Provider Demographics
NPI:1699490391
Name:TIFFANY VU DMD PC
Entity type:Organization
Organization Name:TIFFANY VU DMD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:TRANG TIFFANY
Authorized Official - Middle Name:
Authorized Official - Last Name:VU
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:559-226-4003
Mailing Address - Street 1:5380 N FRESNO ST STE 106
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93710-6847
Mailing Address - Country:US
Mailing Address - Phone:626-315-1812
Mailing Address - Fax:
Practice Address - Street 1:5380 N FRESNO ST STE 106
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93710-6847
Practice Address - Country:US
Practice Address - Phone:626-315-1812
Practice Address - Fax:559-226-4005
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-10-05
Last Update Date:2023-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty