Healthcare Provider Details

I. General information

NPI: 1922923507
Provider Name (Legal Business Name): DR. DENNIS VU
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/12/2026
Last Update Date: 08/12/2026
Certification Date: 08/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

JULIAN C. SMITH ST. BLDG 460
CAMP LEJEUNE NC
28547
US

IV. Provider business mailing address

1639 WILSON AVE
UPLAND CA
91784-1773
US

V. Phone/Fax

Practice location:
  • Phone: 910-451-1658
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number113686
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: