Pristine Dental, Vu Thanh Thai, DMD Inc.

Primary specialty

Preferred Provider OrganizationTaxonomy code 305R00000X

License

56058 Issued in CA

Legal business name

PRISTINE DENTAL, VU THANH THAI, DMD INC.

Practice address

3078 University Ave
San Diego, CA 92104-3034

Phone

(619) 295-8891

Fax

(619) 295-8896

NPI assigned

Jun 28, 2012

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Vu Thanh Thai, DMD

Title

President

Phone

(619) 295-8891

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1340841600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1340841600000",
    "number": "1023372513",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3078 UNIVERSITY AVE",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921043034",
            "telephone_number": "619-295-8891",
            "fax_number": "619-295-8896"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3078 UNIVERSITY AVE",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921043034",
            "telephone_number": "619-295-8891",
            "fax_number": "619-295-8896"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRISTINE DENTAL, VU THANH THAI, DMD INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-06-28",
        "last_updated": "2012-06-28",
        "status": "A",
        "authorized_official_last_name": "THAI",
        "authorized_official_first_name": "VU",
        "authorized_official_middle_name": "THANH",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "619-295-8891",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "305R00000X",
            "taxonomy_group": "",
            "desc": "Preferred Provider Organization",
            "state": "CA",
            "license": "56058",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Charles A. Prior, MD
• Lincoln Gage Prior
• Priscilla Jouvin Psychotherapy
• Lauren Prisco
• Taylor Leigh Priselac, DACM, LAC, DIPL. OM
• Pristine Surgical Incorporated
• Taylor Lyn Pritchard, FNP
• Michael Pritsker, D.C., Q.M.E.
• Private Healthcare Facilities
• Private Healthcare Facilities

• Preferred Provider Organization in San Diego, CA
• Providers in San Diego, CA by specialty
• Preferred Provider Organization in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.