Healthcare Provider Details

I. General information

NPI: 1891421947
Provider Name (Legal Business Name): VICTOR TU DMD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/29/2022
Last Update Date: 08/08/2025
Certification Date: 08/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

45 DOWLIN FORGE RD
EXTON PA
19341-1548
US

IV. Provider business mailing address

1001 VINE ST APT 1303
PHILADELPHIA PA
19107-1324
US

V. Phone/Fax

Practice location:
  • Phone: 610-624-8552
  • Fax:
Mailing address:
  • Phone: 415-367-5719
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code122300000X
TaxonomyDentist
License Number2022029426
License Number StateMO
# 2
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License NumberDS045150
License Number StatePA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: