Provider Demographics
NPI:1487145090
Name:VO THI NGOC LAN DDS INC
Entity type:Organization
Organization Name:VO THI NGOC LAN DDS INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:LAN
Authorized Official - Middle Name:NGOC THI
Authorized Official - Last Name:VO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:626-478-7618
Mailing Address - Street 1:311 E LIVE OAK AVE
Mailing Address - Street 2:
Mailing Address - City:ARCADIA
Mailing Address - State:CA
Mailing Address - Zip Code:91006-5618
Mailing Address - Country:US
Mailing Address - Phone:626-348-8563
Mailing Address - Fax:626-821-0996
Practice Address - Street 1:311 E LIVE OAK AVE
Practice Address - Street 2:
Practice Address - City:ARCADIA
Practice Address - State:CA
Practice Address - Zip Code:91006-5618
Practice Address - Country:US
Practice Address - Phone:626-478-7618
Practice Address - Fax:626-821-0996
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-05-21
Last Update Date:2021-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA58563122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty