Individual provider Active NPI

Vivian Vo, DMD

  • General Practice Dentistry
  • Chicago, IL
National Provider Identifier
1760051312
Registry record updated Jun 18, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
019033205 Issued in IL
Practice address
3425 S King Dr
Chicago, IL 60616-4108
Phone
(312) 313-9777
NPI assigned
Jun 18, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 18, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 019033205 IL Primary

Addresses

Primary practice location

3425 S King Dr
Chicago, IL 60616-4108

Mailing address

17 E Judith Ann Dr
Mount Prospect, IL 60056-2106
Phone (224) 392-4914

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

State licenses

LicenseStateTypeSpecialty
019033205ILMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
King Dental, PC CurrentSince Jun 22, 2021 Accepting new patients

Locations

3425 S King Dr
Chicago, IL 60616
Phone (312) 313-9777

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": "1623974400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623974400000",
    "number": "1760051312",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17 E JUDITH ANN DR",
            "city": "MOUNT PROSPECT",
            "state": "IL",
            "postal_code": "600562106",
            "telephone_number": "224-392-4914"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3425 S KING DR",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606164108",
            "telephone_number": "312-313-9777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VO",
        "first_name": "VIVIAN",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-06-18",
        "last_updated": "2021-06-18",
        "certification_date": "2021-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019033205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2021; 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.