Healthcare Provider Details

I. General information

NPI: 1578108106
Provider Name (Legal Business Name): NAMTHIEN VU, DDS, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/06/2019
Last Update Date: 01/26/2023
Certification Date: 01/26/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

720 OLIVE WAY STE 930
SEATTLE WA
98101-1840
US

IV. Provider business mailing address

720 OLIVE WAY STE 930
SEATTLE WA
98101-1840
US

V. Phone/Fax

Practice location:
  • Phone: 206-292-9980
  • Fax:
Mailing address:
  • Phone: 206-292-9980
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QD0000X
TaxonomyDental Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. NAMTHIEN QUOC VU
Title or Position: DENTIST
Credential: DDS
Phone: 206-292-9980