Individual provider Active NPI

Shu-Yu Chu

  • Dentist
  • Flushing, NY
National Provider Identifier
1053771402
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
059265 Issued in NY
Practice address
4343 Kissena Blvd Ste 117
Flushing, NY 11355-2950
Phone
(718) 888-7832
NPI assigned
Feb 27, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Dentist 122300000X 059265 NY Primary

Addresses

Primary practice location

4343 Kissena Blvd Ste 117
Flushing, NY 11355-2950

Mailing address

102 Birch CT
Cedar Knolls, NJ 07927-2045
Phone (626) 217-8198

Other practice location 1

110 E 40th St Rm 104
New York, NY 10016-1819
Phone (212) 682-2965

Other practice location 2

111 E 210th St
Bronx, NY 10467-2401
Phone (718) 920-4321

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
059265NYMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Expert Dental PC PastSince Nov 1, 2020 Accepting new patients
Trusmile Dental, P.C. PastSince Aug 4, 2024 Accepting new patients

Interoperability endpoints

  • Direct secure messaging: shu.chu.p1@direct.cscla.nextgenshare.com

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1456531200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1053771402",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "102 BIRCH CT",
            "city": "CEDAR KNOLLS",
            "state": "NJ",
            "postal_code": "079272045",
            "telephone_number": "626-217-8198"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4343 KISSENA BLVD STE 117",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113552950",
            "telephone_number": "718-888-7832"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "110 E 40th St Rm 104",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100161819",
            "country_code": "US",
            "telephone_number": "212-682-2965",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "111 E 210th St",
            "address_purpose": "LOCATION",
            "city": "Bronx",
            "state": "NY",
            "postal_code": "104672401",
            "country_code": "US",
            "telephone_number": "718-920-4321",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHU",
        "first_name": "SHU-YU",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-02-27",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NY",
            "license": "059265",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Flushing, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 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.