Individual provider Active NPI

David Te Fu Kuo

  • General Practice Dentistry
  • San Gabriel, CA
National Provider Identifier
1083013288
Registry record updated Aug 14, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
34983 Issued in CA
Practice address
921 S San Gabriel Blvd
San Gabriel, CA 91776-2743
Phone
(626) 872-0738
NPI assigned
Aug 14, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 14, 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 34983 CA Primary

Addresses

Primary practice location

921 S San Gabriel Blvd
San Gabriel, CA 91776-2743

Mailing address

1604 Hilliard Dr
San Marino, CA 91108-3008
Phone (626) 451-0332

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
34983CAMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1407974400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1407974400000",
    "number": "1083013288",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1604 HILLIARD DR",
            "city": "SAN MARINO",
            "state": "CA",
            "postal_code": "911083008",
            "telephone_number": "626-451-0332"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "921 S SAN GABRIEL BLVD",
            "city": "SAN GABRIEL",
            "state": "CA",
            "postal_code": "917762743",
            "telephone_number": "626-872-0738"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUO",
        "first_name": "DAVID",
        "middle_name": "TE FU",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-08-14",
        "last_updated": "2014-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "34983",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Gabriel, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2014; 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.