Individual provider Active NPI

Sarah Vu

  • General Practice Dentistry
  • New York, NY
National Provider Identifier
1992293054
Registry record updated Dec 5, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
061509 Issued in NY
Practice address
111 E 57TH St Ste 204
New York, NY 10022-2009
Phone
(917) 858-7155
NPI assigned
Apr 24, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 5, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 104261 CA
Student in an Organized Health Care Education/Training Program 390200000X
General Practice Dentistry 1223G0001X 061509 NY Primary

Addresses

Primary practice location

111 E 57TH St Ste 204
New York, NY 10022-2009

Mailing address

2455 Jefferson Blvd Ste 130
West Sacramento, CA 95691-5328
Phone (916) 372-8062

Other practice location 1

111 E 210th St
Bronx, NY 10467-2401
Phone (718) 920-4806

Other practice location 2

111 E 210th St
Bronx, NY 10467-2401
Phone (718) 920-4806

Other practice location 3

2455 Jefferson Blvd Ste 130
West Sacramento, CA 95691
Phone (916) 372-8062

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20191016001724 CA Order and Referring Only - DentistPractitioner - Dentist 5597096974

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
061509NYMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Spa Dental Group Inc. CurrentSince Dec 13, 2020 Accepting new patients
Arora Dental PC CurrentSince Dec 21, 2021 Accepting new patients
Dental Corporation of Amardeep Gill DDS General Practice PastSince Aug 1, 2019 Accepting new patients

Locations

111 E 57th St
Rm 204
New York, NY 10022
Phone (917) 512-8302

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1524528000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607126400000",
    "number": "1992293054",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2455 JEFFERSON BLVD STE 130",
            "city": "WEST SACRAMENTO",
            "state": "CA",
            "postal_code": "956915328",
            "telephone_number": "916-372-8062"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 E 57TH ST STE 204",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100222009",
            "telephone_number": "917-858-7155"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "111 E 210th St",
            "address_purpose": "LOCATION",
            "city": "Bronx",
            "state": "NY",
            "postal_code": "104672401",
            "country_code": "US",
            "telephone_number": "718-920-4806",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "111 E 210th St",
            "address_purpose": "LOCATION",
            "city": "Bronx",
            "state": "NY",
            "postal_code": "104672401",
            "country_code": "US",
            "telephone_number": "718-920-4806",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2455 Jefferson Blvd Ste 130",
            "address_purpose": "LOCATION",
            "city": "West Sacramento",
            "state": "CA",
            "postal_code": "95691",
            "country_code": "US",
            "telephone_number": "916-372-8062",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VU",
        "first_name": "SARAH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-04-24",
        "last_updated": "2020-12-05",
        "certification_date": "2020-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "104261",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "061509",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.