Individual provider Active NPI

David Vu, DDS

  • Dentist
  • Santa Ana, CA
National Provider Identifier
1376025635
Registry record updated Feb 20, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
104657 Issued in CA
Practice address
3358 S Bristol St
Santa Ana, CA 92704-8202
Phone
(714) 361-2141
NPI assigned
Sep 4, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 20, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 104657 CA Primary
Dentist 122300000X DD4965 NM

Addresses

Primary practice location

3358 S Bristol St
Santa Ana, CA 92704-8202

Mailing address

5016 W Hazard Ave
Santa Ana, CA 92703-1147
Phone (714) 417-2665

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NM
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
I20181019001345 NM Order and Referring Only - DentistPractitioner - Dentist 5496008559

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
104657CAMDDentist
DD4965NMMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Pham & Vu Dental Partnership Dentist Current Accepting new patients
Familia Dental Ros LLC PastSince Jun 27, 2021 Accepting new patients

Organizations & group practices 2

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": "1536019200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1582156800000",
    "number": "1376025635",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5016 W HAZARD AVE",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927031147",
            "telephone_number": "714-417-2665"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3358 S BRISTOL ST",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927048202",
            "telephone_number": "714-361-2141"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VU",
        "first_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-09-04",
        "last_updated": "2020-02-20",
        "certification_date": "2020-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "104657",
            "primary": true
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NM",
            "license": "DD4965",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Ana, CA

Sources for this page

Verify at the official NPI Registry.