Individual provider Active NPI

Laura Gu, DMD

  • Dentist
  • El Paso, TX
National Provider Identifier
1114612876
Registry record updated Sep 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
41015 Issued in TX
Practice address
9909 Kenworthy St
El Paso, TX 79924-4404
Phone
(915) 755-7639
Fax
(915) 755-0060
NPI assigned
Apr 10, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 30, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 41015 TX Primary

Addresses

Primary practice location

9909 Kenworthy St
El Paso, TX 79924-4404

Mailing address

9909 Kenworthy St
El Paso, TX 79924-4404
Phone (915) 755-7639

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NM
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230705000984 NM Order and Referring Only - DentistPractitioner - Dentist 7113386483

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
41015TXMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Caredds, Inc PastSince Oct 6, 2024 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": "1681084800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727654400000",
    "number": "1114612876",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9909 KENWORTHY ST",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799244404",
            "telephone_number": "915-755-7639"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9909 KENWORTHY ST",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799244404",
            "telephone_number": "915-755-7639",
            "fax_number": "915-755-0060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GU",
        "first_name": "LAURA",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-04-10",
        "last_updated": "2024-09-30",
        "certification_date": "2024-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TX",
            "license": "41015",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in El Paso, TX

Sources for this page

Verify at the official NPI Registry.