MEDICARE: TIMOTHY 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	DDS112428	CA

General Provider Information

NPI Number	:	1730042631
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TIMOTHY VU DDS

Provider Business Mailing Address
First Line	:	1773 FIRTH CT
Second Line	:
City	:	FREMONT
State	:	CA
Zip	:	94539-5936
Country	:	US
Telephone Number	:	510-673-6609
Fax Number	:

Provider Business Practice Location Address
First Line	:	435 S VIRGIL AVE
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90020-1400
Country	:	US
Telephone Number	:	510-673-6609
Fax Number	:

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

Provider Enumeration Date	:	12/08/2025
Last Update Date	:	12/08/2025

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