Phuong Kim Van, D.M.D.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DN 21887 Issued in FL

Practice address

3185 Citrus Tower Blvd
Clermont, FL 34711-6803

Phone

(352) 271-8471

Fax

(352) 271-8472

NPI assigned

Jun 16, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1466035200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1485734400000",
    "number": "1164872578",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3185 CITRUS TOWER BLVD",
            "city": "CLERMONT",
            "state": "FL",
            "postal_code": "347116803",
            "telephone_number": "352-247-8471"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3185 CITRUS TOWER BLVD",
            "city": "CLERMONT",
            "state": "FL",
            "postal_code": "347116803",
            "telephone_number": "352-271-8471",
            "fax_number": "352-271-8472"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAN",
        "first_name": "PHUONG KIM",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-06-16",
        "last_updated": "2017-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN 21887",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Paula P Valle
• Yesenia Vallejo, BSN, RN
• Valor Lakes Health LLC
• Valor Lakes Solutions LLC
• Steven Loren Van Dyke, MA PT
• Vanguard Medical Center LLC
• Nilmarys Zoe Vargas del Valle
• Ernest Vargas
• Amit Bhushan Varma, MD
• Vascular Specialists of Central Florida

• General Practice Dentistry in Clermont, FL
• Providers in Clermont, FL by specialty
• General Practice Dentistry in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2017; 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.