Provider Demographics
NPI:1215093240
Name:VU, KHANG DANG (DMD)
Entity type:Individual
Prefix:DR
First Name:KHANG
Middle Name:DANG
Last Name:VU
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8050 ALONDRA BLVD
Mailing Address - Street 2:SUITE A
Mailing Address - City:PARAMOUNT
Mailing Address - State:CA
Mailing Address - Zip Code:90723-4348
Mailing Address - Country:US
Mailing Address - Phone:562-630-5904
Mailing Address - Fax:562-630-0799
Practice Address - Street 1:8050 ALONDRA BLVD
Practice Address - Street 2:SUITE A
Practice Address - City:PARAMOUNT
Practice Address - State:CA
Practice Address - Zip Code:90723-4348
Practice Address - Country:US
Practice Address - Phone:562-630-5904
Practice Address - Fax:562-630-0799
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-27
Last Update Date:2019-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADDS500121223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAD50012Medicaid
CAG9372801Medicaid