Individual provider Active NPI

Jason Fu, DDS

  • Dentist
  • Huntington Beach, CA
National Provider Identifier
1134587843
Registry record updated Feb 9, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
47620 Issued in CA
Practice address
6552 Bolsa Ave
Ste J
Huntington Beach, CA 92647-2660
Phone
(714) 893-2106
NPI assigned
Feb 9, 2016
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 9, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 47620 CA Primary

Addresses

Primary practice location

6552 Bolsa Ave
Ste J
Huntington Beach, CA 92647-2660

Mailing address

6552 Bolsa Ave
Ste J
Huntington Beach, CA 92647-2660

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

NPI Registry JSON

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

{
    "created_epoch": "1454976000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1454976000000",
    "number": "1134587843",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6552 BOLSA AVE",
            "address_2": "STE J",
            "city": "HUNTINGTON BEACH",
            "state": "CA",
            "postal_code": "926472660"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6552 BOLSA AVE",
            "address_2": "STE J",
            "city": "HUNTINGTON BEACH",
            "state": "CA",
            "postal_code": "926472660",
            "telephone_number": "714-893-2106"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FU",
        "first_name": "JASON",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-02-09",
        "last_updated": "2016-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "47620",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Huntington Beach, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2016; 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.