Individual provider Active NPI

Victoria Kim Vuong, D.D.S.

  • Dentist
  • San Jose, CA
National Provider Identifier
1174655179
Registry record updated Jan 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
44555 Issued in CA
Practice address
3151 S. White Road
Suite 203
San Jose, CA 95148
Phone
(408) 238-7646
Fax
(408) 238-8096
NPI assigned
Mar 12, 2007
Last updated
Jan 11, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 11, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 44555 CA
Dentist 122300000X 44555 CA Primary

Addresses

Primary practice location

3151 S. White Road
Suite 203
San Jose, CA 95148

Mailing address

3151 S. White Road
Suite 203
San Jose, CA 95148
Phone (408) 238-7646

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20160910000301 CA Order and Referring Only - DentistPractitioner - Dentist 5193011559

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
44555CAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Henry S Chang DDS Inc Dentist PastSince Jan 15, 2023 Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1173657600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1673395200000",
    "number": "1174655179",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3151 S. WHITE ROAD",
            "address_2": "SUITE 203",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "95148",
            "telephone_number": "408-238-7646",
            "fax_number": "408-238-8096"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3151 S. WHITE ROAD",
            "address_2": "SUITE 203",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "95148",
            "telephone_number": "408-238-7646",
            "fax_number": "408-238-8096"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VUONG",
        "first_name": "VICTORIA",
        "middle_name": "KIM",
        "name_prefix": "Mrs.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-12",
        "last_updated": "2023-01-11",
        "certification_date": "2023-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "44555",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "44555",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Jose, CA

Sources for this page

Verify at the official NPI Registry.