Provider Demographics
NPI:1750980991
Name:VU, BRIAN LONG HOANG (DDS)
Entity type:Individual
Prefix:DR
First Name:BRIAN
Middle Name:LONG HOANG
Last Name:VU
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3101 S FAIRVIEW ST SPC 43
Mailing Address - Street 2:
Mailing Address - City:SANTA ANA
Mailing Address - State:CA
Mailing Address - Zip Code:92704-6566
Mailing Address - Country:US
Mailing Address - Phone:714-858-0784
Mailing Address - Fax:
Practice Address - Street 1:9200 BOLSA AVE STE 209
Practice Address - Street 2:
Practice Address - City:WESTMINSTER
Practice Address - State:CA
Practice Address - Zip Code:92683-5580
Practice Address - Country:US
Practice Address - Phone:714-858-0784
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-20
Last Update Date:2020-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA105721122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist