Individual provider Active NPI

Peter Luu, D.D.S.

  • General Practice Dentistry
  • Azusa, CA
National Provider Identifier
1104016419
Registry record updated Sep 8, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
55933 Issued in CA
Practice address
706 N Azusa Ave
Azusa, CA 91702-2507
Phone
(626) 334-7310
NPI assigned
Aug 1, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 8, 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 55933 CA Primary

Addresses

Primary practice location

706 N Azusa Ave
Azusa, CA 91702-2507

Mailing address

706 N Azusa Ave
Azusa, CA 91702-2507

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)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Enoma Alade, DDS, Inc PastSince Aug 29, 2017 Accepting new patients

Organizations & group practices 1

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": "1185926400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1410134400000",
    "number": "1104016419",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "706 N AZUSA AVE",
            "city": "AZUSA",
            "state": "CA",
            "postal_code": "917022507"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "706 N AZUSA AVE",
            "city": "AZUSA",
            "state": "CA",
            "postal_code": "917022507",
            "telephone_number": "626-334-7310"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUU",
        "first_name": "PETER",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-08-01",
        "last_updated": "2014-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "55933",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Azusa, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 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.