Provider Demographics
NPI:1972546547
Name:DANG, VINH (MPAS, PA-C)
Entity type:Individual
Prefix:
First Name:VINH
Middle Name:
Last Name:DANG
Suffix:
Gender:M
Credentials:MPAS, PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8100 W 78TH ST
Mailing Address - Street 2:STE. 225
Mailing Address - City:EDINA
Mailing Address - State:MN
Mailing Address - Zip Code:55439-2516
Mailing Address - Country:US
Mailing Address - Phone:952-946-9777
Mailing Address - Fax:
Practice Address - Street 1:8100 W 78TH ST
Practice Address - Street 2:SUITE 225
Practice Address - City:EDINA
Practice Address - State:MN
Practice Address - Zip Code:55439-2516
Practice Address - Country:US
Practice Address - Phone:952-946-9777
Practice Address - Fax:952-946-9888
Is Sole Proprietor?:No
Enumeration Date:2006-06-13
Last Update Date:2021-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN9738363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN0110114OtherSELECT CARE
MN411896434OtherTRIWEST
MN1032306OtherPREFERRED ONE
MN970029985OtherRAILROAD MEDICARE
MN301T3DAOtherBLUE CROSS/SHIELD
MNHP37391OtherHEALTHPARTNERS
MN0110114OtherMEDICA
MN120003727OtherWEA
MN211093800Medicaid
MN143503E505OtherUCARE
MN970029985OtherRAILROAD MEDICARE
MN143503E505OtherUCARE