Individual provider Active NPI

Jasper Lu, DDS

  • Dentist
  • Seattle, WA
National Provider Identifier
1033716006
Registry record updated Apr 8, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
1002450-15 Issued in WI
Practice address
401 NE Northgate Way
Seattle, WA 98125-6036
Phone
(206) 336-2100
NPI assigned
Oct 2, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 8, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 1002450-15 WI Primary

Addresses

Primary practice location

401 NE Northgate Way
Seattle, WA 98125-6036

Mailing address

4340 Colchester Dr
Richmond, BC V7C 4R4
CA

Other practice location 1

142 E Capitol Dr
Milwaukee, WI 53212-1206
Phone (141) 444-4182

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
1002450-15WIMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1601596800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649376000000",
    "number": "1033716006",
    "addresses": [
        {
            "country_code": "CA",
            "country_name": "Canada",
            "address_purpose": "MAILING",
            "address_type": "FGN",
            "address_1": "4340 COLCHESTER DR",
            "city": "RICHMOND",
            "state": "BC",
            "postal_code": "V7C 4R4"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 NE NORTHGATE WAY",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981256036",
            "telephone_number": "206-336-2100"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "142 E Capitol Dr",
            "address_purpose": "LOCATION",
            "city": "Milwaukee",
            "state": "WI",
            "postal_code": "532121206",
            "country_code": "US",
            "telephone_number": "141-444-4182",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LU",
        "first_name": "JASPER",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-10-02",
        "last_updated": "2022-04-08",
        "certification_date": "2022-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WI",
            "license": "1002450-15",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.