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General NPI Number Information
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NPI Number | 1053755942
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Entity Type | Organization
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Legal Business Name | V.MAI DDS INC
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Dates
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Enumeration Date | 04/22/2013
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Last Update Date | 09/28/2015
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Provider Practice Location Address
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Address Line | 810 AVENIDA PICO STE W
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City | SAN CLEMENTE
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State | CA
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Zip | 92673-5624
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Country | US
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Telephone | 949-369-7200
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Fax | 949-369-7700
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Provider Business Mailing Address
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Address Line | 810 AVENIDA PICO STE W
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City | SAN CLEMENTE
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State | CA
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Zip | 92673-5624
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Country | US
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Telephone | 949-369-7200
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Fax | 949-369-7700
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Authorized Official
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Title or Position | CEO
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Name | DR. VU MAI
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Credential | DDS
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Telephone | 949-369-7200
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223D0001X
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Taxonomy Name | Public Health Dentistry
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 1223E0200X
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Taxonomy Name | Endodontics
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 1223P0300X
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Taxonomy Name | Periodontics
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 1223P0700X
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Taxonomy Name | Prosthodontics
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 1223S0112X
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Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number |
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License Number State |
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Taxonomy #7
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Taxonomy Code | 124Q00000X
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Taxonomy Name | Dental Hygienist
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License Number |
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License Number State |
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Taxonomy #8
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Taxonomy Code | 126800000X
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Taxonomy Name | Dental Assistant
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License Number |
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License Number State |
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Taxonomy #9
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number |
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License Number State |
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