Individual provider Active NPI

Tram Anh Monique Cao Vu, DDS

  • General Practice Dentistry
  • Slidell, LA
National Provider Identifier
1063142347
Registry record updated Jun 10, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
7338 Issued in LA
Practice address
420 Town Center Pkwy
Slidell, LA 70458-8000
Phone
(985) 214-1540
NPI assigned
Jun 10, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 10, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 7338 LA Primary

Addresses

Primary practice location

420 Town Center Pkwy
Slidell, LA 70458-8000

Mailing address

110 Torrey Pines Dr
New Orleans, LA 70128-3632
Phone (504) 756-4312

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221020000926 LA Order and Referring Only - DentistPractitioner - Dentist 5193191831

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
7338LAMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Jacob Dent DDS Dentists of Slidell a Professional Corporation PastSince Jun 12, 2022 Accepting new patients

Networks

  • LA PPO C-SNP

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1654819200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654819200000",
    "number": "1063142347",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 TORREY PINES DR",
            "city": "NEW ORLEANS",
            "state": "LA",
            "postal_code": "701283632",
            "telephone_number": "504-756-4312"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "420 TOWN CENTER PKWY",
            "city": "SLIDELL",
            "state": "LA",
            "postal_code": "704588000",
            "telephone_number": "985-214-1540"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VU",
        "first_name": "TRAM ANH MONIQUE",
        "middle_name": "CAO",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-06-10",
        "last_updated": "2022-06-10",
        "certification_date": "2022-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "LA",
            "license": "7338",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Slidell, LA

Sources for this page

Verify at the official NPI Registry.