Individual provider Active NPI

Nicole Vu, DMD

  • Endodontics
  • Orlando, FL
National Provider Identifier
1629231949
Registry record updated Jul 22, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
EndodonticsTaxonomy code 1223E0200X
License
DN18439 Issued in FL
Practice address
7319 W Colonial Dr
Orlando, FL 32818-6746
Phone
(407) 294-9200
Fax
(407) 294-1577
NPI assigned
Jul 7, 2008
Last updated
Jul 22, 2013By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 22, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DN18439 FL
Endodontics 1223E0200X DN18439 FL Primary

Addresses

Primary practice location

7319 W Colonial Dr
Orlando, FL 32818-6746

Mailing address

2914 Willow Bay Ter
Casselberry, FL 32707-6733
Phone (215) 203-4679

Other names 1

  • Van Bao Vu Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20150526000752 FL Order and Referring Only - Other (Physician)Practitioner - Other (Physician) 2769702281

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DN18439FLMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1215388800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1374451200000",
    "number": "1629231949",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2914 WILLOW BAY TER",
            "city": "CASSELBERRY",
            "state": "FL",
            "postal_code": "327076733",
            "telephone_number": "215-203-4679"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7319 W COLONIAL DR",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328186746",
            "telephone_number": "407-294-9200",
            "fax_number": "407-294-1577"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VU",
        "first_name": "NICOLE",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-07-07",
        "last_updated": "2013-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "FL",
            "license": "DN18439",
            "primary": false
        },
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "FL",
            "license": "DN18439",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "VAN",
            "last_name": "VU",
            "middle_name": "BAO",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Orlando, FL

Sources for this page

Verify at the official NPI Registry.