MEDICARE: TRI MINH 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	1223G0001X	General Practice Dentistry	34001	TX
2	1223G0001X	General Practice Dentistry	00204172	CO

General Provider Information

NPI Number	:	1154815058
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TRI MINH VU DDS

Provider Business Mailing Address
First Line	:	2983 W EVANS AVE
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80219-5507
Country	:	US
Telephone Number	:	469-818-1368
Fax Number	:	720-738-8888

Provider Business Practice Location Address
First Line	:	2983 W EVANS AVE
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80219-5507
Country	:	US
Telephone Number	:	469-818-1368
Fax Number	:	720-738-8888

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

Provider Enumeration Date	:	06/14/2018
Last Update Date	:	09/14/2021

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Directions to “ TRI MINH VU DDS” Practice Location

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