Provider Demographics
NPI:1992258792
Name:VU, JACLYN TRAN (DDS)
Entity type:Individual
Prefix:
First Name:JACLYN
Middle Name:TRAN
Last Name:VU
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9417 MESA DR
Mailing Address - Street 2:STE #A
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77028-1253
Mailing Address - Country:US
Mailing Address - Phone:713-491-0727
Mailing Address - Fax:
Practice Address - Street 1:9417 MESA DR
Practice Address - Street 2:STE #A
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77028-1253
Practice Address - Country:US
Practice Address - Phone:713-491-0727
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-07-27
Last Update Date:2016-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX32050122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist