MEDICARE: DR. MAI CHI SAMANTHA VU D.M.D. , MS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223X0400X	Orthodontics and Dentofacial Orthopedics Dentistry	D6024	AZ

General Provider Information

NPI Number	:	1972631463
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MAI CHI SAMANTHA VU D.M.D. , MS

Provider Business Mailing Address
First Line	:	3336 E CHANDLER HEIGHTS RD
Second Line	:	BUILDING B, SUITE 111
City	:	GILBERT
State	:	AZ
Zip	:	85297-4259
Country	:	US
Telephone Number	:	480-988-0028
Fax Number	:	480-988-6414

Provider Business Practice Location Address
First Line	:	3336 E CHANDLER HEIGHTS RD
Second Line	:	BUILDING B, SUITE 111
City	:	GILBERT
State	:	AZ
Zip	:	85297-4259
Country	:	US
Telephone Number	:	480-988-0028
Fax Number	:	480-988-6414

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/28/2007
Last Update Date	:	09/25/2024

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