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NPI Code Detail

MEDICARE: DR. TUAN VU DDS

MEDICARE: DR. TUAN 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
1122300000XDentist8251VA
2122300000XDentistDN012243GA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1106212OTHERVASMILE FOR CHILDREN

General Provider Information

NPI Number : 1104801117
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. TUAN VU DDS
Provider Business Mailing Address
First Line : 826 S DINWIDDIE ST
Second Line :
City : ARLINGTON
State : VA
Zip : 22204-2912
Country : US
Telephone Number : 703-845-2858
Fax Number :
Provider Business Practice Location Address
First Line : 3608 FOREST DR
Second Line :
City : ALEXANDRIA
State : VA
Zip : 22302-1043
Country : US
Telephone Number : 703-671-8431
Fax Number : 703-671-3511
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/13/2005
Last Update Date : 07/09/2007

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