Jolyn Su, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

DE00010326 Issued in WA

Practice address

1426 112TH Ave NE
Bellevue, WA 98004-3710

Phone

(425) 455-2370

Fax

(425) 455-8509

NPI assigned

Dec 18, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

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 and National Provider Directory roles.

• Jolyn a. Su, DDS, PLLC

  • General Practice Dentistry
  • Bellevue, WA
  • NPI 1134577893
  NPD (past) Authorized official

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

{
    "created_epoch": "1166400000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1468454400000",
    "number": "1013070317",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1426 112TH AVE NE",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980043710",
            "telephone_number": "425-455-2370",
            "fax_number": "425-455-8509"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1426 112TH AVE NE",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980043710",
            "telephone_number": "425-455-2370",
            "fax_number": "425-455-8509"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SU",
        "first_name": "JOLYN",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-18",
        "last_updated": "2016-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WA",
            "license": "DE00010326",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Chen Su, M.S.
• Cindy Su, LMHCA
• Dan Su, FNP-C
• Helen Su
• Jia Su, PHARM. D
• Theodore Su, DPT
• Yi Su
• Su's Holistic Healing PLLC
• Angelica Suarez
• Lara Subhash

• Dentist in Bellevue, WA
• Providers in Bellevue, WA by specialty
• Dentist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2016; 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.