Jennie Vu, D.M.D

Primary specialty

DentistTaxonomy code 122300000X

License

D10130 Issued in OR

Practice address

12520 SW 1St St
Beaverton, OR 97005-0550

Phone

(503) 646-5230

NPI assigned

Aug 27, 2014

Last updated

Oct 1, 2018By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in OR

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Beaverton Sandy Dental Clinic PC

  • General Practice Dentistry
  • Beaverton, OR
  • NPI 1528574829
  NPD (past)
• Sandy Dental Clinic PC

  • General Practice Dentistry
  • Beaverton, OR
  • NPI 1699818088
  NPD (past)

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

{
    "created_epoch": "1409097600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1538352000000",
    "number": "1699175620",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12520 SW 1ST ST",
            "city": "BEAVERTON",
            "state": "OR",
            "postal_code": "970050550",
            "telephone_number": "503-646-5230"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12520 SW 1ST ST",
            "city": "BEAVERTON",
            "state": "OR",
            "postal_code": "970050550",
            "telephone_number": "503-646-5230"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VU",
        "first_name": "JENNIE",
        "credential": "D.M.D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-08-27",
        "last_updated": "2018-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WA",
            "license": "DE60496474",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "OR",
            "license": "D10130",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tami Cheri Von Linsowe-Wilson
• Ammata Vongsouvanh, PHARM. D
• Hanna Voronina
• Christopher Vorrath, PHARMACIST
• Mary Christine Vrontakis, RN
• Kim CHI Vu, M.D.
• Tyler Vuong
• VW Wellness LLC
• W/You
• Joanna Wagner, MENTAL HEALTH INTERN

• Dentist in Beaverton, OR
• Providers in Beaverton, OR by specialty
• Dentist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2018; 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.

Verify at the official NPI Registry.