Individual provider Active NPI

Suzan Fu, DDS

  • Dentist
  • Las Vegas, NV
National Provider Identifier
1144238049
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
3732 Issued in NV
Practice address
1958 Village Center Circle
Suite #4
Las Vegas, NV 89134
Phone
(702) 914-6600
Fax
(702) 878-6688
NPI assigned
Aug 4, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 3732 NV Primary
Dentist 122300000X 47260 CA
Dentist 122300000X 5308 AZ

Addresses

Primary practice location

1958 Village Center Circle
Suite #4
Las Vegas, NV 89134

Mailing address

1958 Village Center Circle
Suite #4
Las Vegas, NV 89134
Phone (702) 914-6600

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

State licenses

LicenseStateTypeSpecialty
3732NVMDDentist
47260CAMDPharmacist
5308AZMDOccupational Therapy Assistant

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1154649600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1144238049",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1958 VILLAGE CENTER CIRCLE",
            "address_2": "SUITE #4",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "89134",
            "telephone_number": "702-914-6600",
            "fax_number": "702-878-6688"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1958 VILLAGE CENTER CIRCLE",
            "address_2": "SUITE #4",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "89134",
            "telephone_number": "702-914-6600",
            "fax_number": "702-878-6688"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FU",
        "first_name": "SUZAN",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-04",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NV",
            "license": "3732",
            "primary": true
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "47260",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "AZ",
            "license": "5308",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.