Active NPI
Khac Phuong Vu, D.M.D
- General Practice Dentistry
- Louisville, KY
National Provider Identifier
1447661210
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 9408
- Practice address
- 3448 Taylor Boulevard
Louisville, KY 40215 - Phone
- (502) 366-6821
- NPI assigned
- May 15, 2014
- Sex
- Male
- Sole proprietor
- Yes
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 | 9408 | KY | Primary |
Addresses
Primary practice location
3448 Taylor Boulevard
Louisville, KY 40215
Mailing address
3448 Taylor Blvd
Louisville, KY 40215
Phone (502) 366-6821
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in KY
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160208001428 | KY | Order and Referring Only - Oral Surgery | 1850695198 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1400112000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1417478400000",
"number": "1447661210",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3448 TAYLOR BLVD",
"city": "LOUISVILLE",
"state": "KY",
"postal_code": "40215",
"telephone_number": "502-366-6821"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3448 TAYLOR BOULEVARD",
"city": "LOUISVILLE",
"state": "KY",
"postal_code": "40215",
"telephone_number": "502-366-6821"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VU",
"first_name": "KHAC PHUONG",
"name_prefix": "Mr.",
"credential": "D.M.D",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2014-05-15",
"last_updated": "2014-12-02",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "KY",
"license": "9408",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Louisville, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.