Individual provider Active NPI

Vu Quach, DMD

  • Dentist
  • Austin, TX
National Provider Identifier
1639520844
Registry record updated Dec 11, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
35622 Issued in TX
Practice address
2717 S Lamar Blvd Apt 1086
Austin, TX 78704-0139
Phone
(512) 717-5315
NPI assigned
Jun 29, 2016
Last updated
Dec 11, 2022By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 11, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 35622 TX Primary

Addresses

Primary practice location

2717 S Lamar Blvd Apt 1086
Austin, TX 78704-0139

Mailing address

16532 Summery St
Manor, TX 78653-5455

Other practice location 1

15930 S Great Oaks Dr Ste A100
Round Rock, TX 78681-5686
Phone (512) 255-3800

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
I20160715001498 NM Order and Referring Only - DentistPractitioner - Dentist 6103118823

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
35622TXMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Essential Dental Manor PLLC CurrentSince Mar 11, 2025 Accepting new patients
Familia Dental Los Lunas LLC Dentist PastSince Jun 27, 2021 Accepting new patients
Enamel Dentistry South Lamar PLLC PastSince Dec 13, 2022 Accepting new patients

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1467158400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670716800000",
    "number": "1639520844",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16532 SUMMERY ST",
            "city": "MANOR",
            "state": "TX",
            "postal_code": "786535455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2717 S LAMAR BLVD APT 1086",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787040139",
            "telephone_number": "512-717-5315"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "15930 S Great Oaks Dr Ste A100",
            "address_purpose": "LOCATION",
            "city": "Round Rock",
            "state": "TX",
            "postal_code": "786815686",
            "country_code": "US",
            "telephone_number": "512-255-3800",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "QUACH",
        "first_name": "VU",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-06-29",
        "last_updated": "2022-12-11",
        "certification_date": "2022-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TX",
            "license": "35622",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Austin, TX

Sources for this page

Verify at the official NPI Registry.