Active NPI
Son Xuan Vu, DDS
- General Practice Dentistry
- Travis Afb, CA
National Provider Identifier
1134110877
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 19817
- Practice address
- 60 MDG/SGDD
101 Bodin Circle
Travis Afb, CA 94535-1800 - Phone
- (707) 423-7000
- NPI assigned
- Nov 2, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 19817 | TX | Primary |
Addresses
Primary practice location
60 MDG/SGDD
101 Bodin Circle
Travis Afb, CA 94535-1800
Mailing address
60 MDG/SGDD
101 Bodin Circle
Travis Afb, CA 94535-1800
Phone (707) 423-7000
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 19817 | Other | TX | TEXAS DENTAL LICENSE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 19817 | TX | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1130889600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1752537600000",
"number": "1134110877",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "60 MDG/SGDD",
"address_2": "101 BODIN CIRCLE",
"city": "TRAVIS AFB",
"state": "CA",
"postal_code": "945351800",
"telephone_number": "707-423-7000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "60 MDG/SGDD",
"address_2": "101 BODIN CIRCLE",
"city": "TRAVIS AFB",
"state": "CA",
"postal_code": "945351800",
"telephone_number": "707-423-7000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VU",
"first_name": "SON",
"middle_name": "XUAN",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-11-02",
"last_updated": "2025-07-15",
"certification_date": "2025-07-01",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "TX",
"license": "19817",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TEXAS DENTAL LICENSE",
"identifier": "19817",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in Travis Afb, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.