Provider Demographics
NPI:1063432961
Name:VU, DOAN DUY (DDS)
Entity type:Individual
Prefix:
First Name:DOAN
Middle Name:DUY
Last Name:VU
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1870 ALUM ROCK AVE
Mailing Address - Street 2:SUITE B
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95116-1303
Mailing Address - Country:US
Mailing Address - Phone:408-272-0919
Mailing Address - Fax:408-729-8704
Practice Address - Street 1:1870 ALUM ROCK AVE
Practice Address - Street 2:SUITE B
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95116-1303
Practice Address - Country:US
Practice Address - Phone:408-272-0919
Practice Address - Fax:408-729-8704
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-20
Last Update Date:2016-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA50013122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA50013OtherDENIST LICENSE
CA50013OtherDENIST LICENSE