Individual provider Active NPI

Katarina Tu, D.D.S.

  • General Practice Dentistry
  • San Mateo, CA
National Provider Identifier
1023427606
Registry record updated Aug 7, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
63855 Issued in CA
Practice address
730 Mariners Island Blvd
Apt 37
San Mateo, CA 94404-1553
Phone
(206) 851-7263
NPI assigned
Aug 7, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 7, 2014

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 63855 CA Primary

Addresses

Primary practice location

730 Mariners Island Blvd
Apt 37
San Mateo, CA 94404-1553

Mailing address

730 Mariners Island Blvd Apt 37
San Mateo, CA 94404-1504
Phone (206) 851-7263

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
I20151207002923 CA Order and Referring Only - DentistPractitioner - Dentist 1355641788

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
63855CAMDMassage Therapist

NPI Registry JSON

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

{
    "created_epoch": "1407369600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1407369600000",
    "number": "1023427606",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "730 MARINERS ISLAND BLVD APT 37",
            "city": "SAN MATEO",
            "state": "CA",
            "postal_code": "944041504",
            "telephone_number": "206-851-7263"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "730 MARINERS ISLAND BLVD",
            "address_2": "APT 37",
            "city": "SAN MATEO",
            "state": "CA",
            "postal_code": "944041553",
            "telephone_number": "206-851-7263"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TU",
        "first_name": "KATARINA",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-08-07",
        "last_updated": "2014-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "63855",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Mateo, CA

Sources for this page

Verify at the official NPI Registry.