Provider Demographics
NPI:1154060846
Name:TRAN, VU NGUYEN (DMD)
Entity type:Individual
Prefix:DR
First Name:VU
Middle Name:NGUYEN
Last Name:TRAN
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11727 ABESS BLVD APT 1327
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32225-6055
Mailing Address - Country:US
Mailing Address - Phone:321-276-9798
Mailing Address - Fax:
Practice Address - Street 1:12420 SAN JOSE BLVD
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32223-2643
Practice Address - Country:US
Practice Address - Phone:904-901-4691
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-01
Last Update Date:2025-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GADN122754122300000X
CO00205412122300000X
FLDN30238122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist