Organization Active NPI

Athena Vu DDS PLLC.

Doing business as Premier Dental

  • Dentist
  • Albemarle, NC
National Provider Identifier
1508248279
Registry record updated Jun 22, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
Legal business name
ATHENA VU DDS PLLC.
Doing business as
Premier Dental
Practice address
1122 North 6TH Street
Albemarle, NC 28001
Phone
(704) 982-5516
Fax
(704) 983-8985
NPI assigned
Jun 18, 2015
Last updated
Jun 22, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 22, 2015

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

Authorized official

Name
Athena Vu, DDSNPI 1518252527
Title
Dentist/Owner
Phone
(704) 500-1355

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X NU Primary

Addresses

Primary practice location

1122 North 6TH Street
Albemarle, NC 28001

Mailing address

1122 North 6TH Street
Albemarle, NC 28001
Phone (704) 982-5516

Other identifiers 1

IdentifierTypeStateIssuer
5918823MedicaidNC

Other names 1

  • Premier Dental Doing business as

National Provider Directory

National Provider Directory

Locations

1122 N 6th St
Albemarle, NC 28001
Phone (704) 982-5516

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1434585600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1434931200000",
    "number": "1508248279",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1122 NORTH 6TH STREET",
            "city": "ALBEMARLE",
            "state": "NC",
            "postal_code": "28001",
            "telephone_number": "704-982-5516",
            "fax_number": "704-983-8985"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1122 NORTH 6TH STREET",
            "city": "ALBEMARLE",
            "state": "NC",
            "postal_code": "28001",
            "telephone_number": "704-982-5516",
            "fax_number": "704-983-8985"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ATHENA VU DDS PLLC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-06-18",
        "last_updated": "2015-06-22",
        "status": "A",
        "authorized_official_last_name": "VU",
        "authorized_official_first_name": "ATHENA",
        "authorized_official_title_or_position": "DENTIST/OWNER",
        "authorized_official_telephone_number": "704-500-1355",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5918823",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Premier Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Albemarle, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2015; 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.