MEDICARE: AN THIEN VU DDS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	122300000X	Dentist	DDS110843	CA

General Provider Information

NPI Number	:	1023679180
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AN THIEN VU DDS

Provider Business Mailing Address
First Line	:	4301 MORNINGSIDE AVE
Second Line	:
City	:	SANTA ANA
State	:	CA
Zip	:	92703-1328
Country	:	US
Telephone Number	:	714-548-9743
Fax Number	:

Provider Business Practice Location Address
First Line	:	9938 BOLSA AVE STE 106
Second Line	:
City	:	WESTMINSTER
State	:	CA
Zip	:	92683-6039
Country	:	US
Telephone Number	:	714-531-1192
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/27/2019
Last Update Date	:	06/26/2026

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