Individual provider Active NPI

Andrew Thien Vo, DDS, MS

  • Pediatric Dentistry
  • Costa Mesa, CA
National Provider Identifier
1629444898
Registry record updated Feb 26, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
64579 Issued in CA
Practice address
2675 Irvine Ave Ste 116
Costa Mesa, CA 92627-6604
Phone
(949) 335-7303
Fax
(949) 335-7304
NPI assigned
Aug 11, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 26, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 30.026047 OH
Pediatric Dentistry 1223P0221X 30.026047 OH
Pediatric Dentistry 1223P0221X 64579 CA Primary

Addresses

Primary practice location

2675 Irvine Ave Ste 116
Costa Mesa, CA 92627-6604

Mailing address

2675 Irvine Ave Ste 116
Costa Mesa, CA 92627-6604
Phone (949) 335-7303

Other practice location 1

1650 Cochrane Cir # B7500
Fort Carson, CO 80913-4613
Phone (719) 526-4807

Other identifiers 1

IdentifierTypeStateIssuer
0390437MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
30.026047OHMDDentist
64579CAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Andrew T Vo, D.D.S., a Professional Corporation. Pediatric Dentistry Current Accepting new patients

Locations

2675 Irvine Ave
Ste 116
Costa Mesa, CA 92627
Phone (949) 335-7303

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1439251200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740528000000",
    "number": "1629444898",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2675 IRVINE AVE STE 116",
            "city": "COSTA MESA",
            "state": "CA",
            "postal_code": "926276604",
            "telephone_number": "949-335-7303",
            "fax_number": "949-335-7304"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2675 IRVINE AVE STE 116",
            "city": "COSTA MESA",
            "state": "CA",
            "postal_code": "926276604",
            "telephone_number": "949-335-7303",
            "fax_number": "949-335-7304"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1650 Cochrane Cir # B7500",
            "address_purpose": "LOCATION",
            "city": "Fort Carson",
            "state": "CO",
            "postal_code": "809134613",
            "country_code": "US",
            "telephone_number": "719-526-4807",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VO",
        "first_name": "ANDREW",
        "middle_name": "THIEN",
        "name_prefix": "Dr.",
        "credential": "DDS, MS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-08-11",
        "last_updated": "2025-02-26",
        "certification_date": "2025-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "OH",
            "license": "30.026047",
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "OH",
            "license": "30.026047",
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "CA",
            "license": "64579",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0390437",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Costa Mesa, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2025; 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.