Provider Demographics
NPI:1124239025
Name:VU, THUY NGA LE (DDS)
Entity type:Individual
Prefix:DR
First Name:THUY NGA
Middle Name:LE
Last Name:VU
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8535 SHEBA CT
Mailing Address - Street 2:
Mailing Address - City:GRANITE BAY
Mailing Address - State:CA
Mailing Address - Zip Code:95746-6286
Mailing Address - Country:US
Mailing Address - Phone:916-787-1232
Mailing Address - Fax:916-209-8744
Practice Address - Street 1:508 GIBSON DR.
Practice Address - Street 2:BLDG 10, STE 190
Practice Address - City:ROSEVILLE
Practice Address - State:CA
Practice Address - Zip Code:95678
Practice Address - Country:US
Practice Address - Phone:916-787-1232
Practice Address - Fax:916-209-8744
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-24
Last Update Date:2008-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA38766122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist