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General NPI Number Information
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NPI Number | 1750399606
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Entity Type | Individual
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Provider Name | LINH NGOC VAN DDS
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Gender | Female
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Dates
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Enumeration Date | 08/04/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1667 DOMINICAN WAY SUITE 232
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City | SANTA CRUZ
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State | CA
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Zip | 95065-1518
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Country | US
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Telephone | 831-476-5512
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Fax |
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Provider Business Mailing Address
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Address Line | 3330 MICHELANGELO DR
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City | SAN JOSE
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State | CA
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Zip | 95135-1749
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Country | US
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Telephone | 415-902-0226
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Fax | 408-521-0722
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number | 50389
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License Number State | CA
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