Active NPI
Di Wu, DDS
- Pediatric Dentistry
- Houston, TX
National Provider Identifier
1063757623
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Dentistry
- License
- 30384
- Practice address
- 6655 Travis St
#460, Pediatric Dentistry
Houston, TX 77030-1312 - Phone
- (734) 945-0451
- NPI assigned
- Dec 6, 2012
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Dentistry | 1223P0221X | 2901020851 | MI | |
| Student in an Organized Health Care Education/Training Program | 390200000X | 2901020851 | MI | |
| Pediatric Dentistry | 1223P0221X | 30384 | TX | Primary |
Addresses
Primary practice location
6655 Travis St
#460, Pediatric Dentistry
Houston, TX 77030-1312
Mailing address
6655 Travis St
#460, Pediatric Dentistry
Houston, TX 77030-1312
Phone (734) 945-0451
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3390767-01 | Medicaid | TX |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 30384 | TX | MD | School Psychologist |
| 2901020851 | MI | MD | Student in an Organized Health Care Education/Training Program |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1354752000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1484006400000",
"number": "1063757623",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6655 TRAVIS ST",
"address_2": "#460, PEDIATRIC DENTISTRY",
"city": "HOUSTON",
"state": "TX",
"postal_code": "770301312",
"telephone_number": "734-945-0451"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6655 TRAVIS ST",
"address_2": "#460, PEDIATRIC DENTISTRY",
"city": "HOUSTON",
"state": "TX",
"postal_code": "770301312",
"telephone_number": "734-945-0451"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WU",
"first_name": "DI",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-12-06",
"last_updated": "2017-01-10",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0221X",
"taxonomy_group": "",
"desc": "Dentist, Pediatric Dentistry",
"state": "MI",
"license": "2901020851",
"primary": false
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": "MI",
"license": "2901020851",
"primary": false
},
{
"code": "1223P0221X",
"taxonomy_group": "",
"desc": "Dentist, Pediatric Dentistry",
"state": "TX",
"license": "30384",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3390767-01",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in Houston, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.