Provider Demographics
NPI:1962710616
Name:VU, VINH KIM (DDS)
Entity type:Individual
Prefix:DR
First Name:VINH
Middle Name:KIM
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 1:3000 SW 104TH ST STE 5
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73159-7014
Mailing Address - Country:US
Mailing Address - Phone:405-703-7070
Mailing Address - Fax:405-703-7072
Practice Address - Street 1:3000 SW 104TH ST STE 5
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73159-7014
Practice Address - Country:US
Practice Address - Phone:405-703-7070
Practice Address - Fax:405-703-7072
Is Sole Proprietor?:No
Enumeration Date:2010-09-15
Last Update Date:2012-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK6241122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist