Individual provider Active NPI

Angelina Fu, DMD

  • General Practice Dentistry
  • Renton, WA
National Provider Identifier
1174737803
Registry record updated Aug 21, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DE00010535 Issued in WA
Practice address
4915 Shattuck PL S
Unit Aa101
Renton, WA 98055-6349
Phone
(206) 877-2911
NPI assigned
May 10, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 21, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X DE00010535 WA Primary
Dentist 122300000X 8180 KY

Addresses

Primary practice location

4915 Shattuck PL S
Unit Aa101
Renton, WA 98055-6349

Mailing address

4915 Shattuck PL S
Unit Aa101
Renton, WA 98055-6349
Phone (206) 877-2911

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
8180KYMDDentist
DE00010535WAMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1178755200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1377043200000",
    "number": "1174737803",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4915 SHATTUCK PL S",
            "address_2": "UNIT AA101",
            "city": "RENTON",
            "state": "WA",
            "postal_code": "980556349",
            "telephone_number": "206-877-2911"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4915 SHATTUCK PL S",
            "address_2": "UNIT AA101",
            "city": "RENTON",
            "state": "WA",
            "postal_code": "980556349",
            "telephone_number": "206-877-2911"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FU",
        "first_name": "ANGELINA",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-10",
        "last_updated": "2013-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WA",
            "license": "DE00010535",
            "primary": true
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "KY",
            "license": "8180",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Renton, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2013; 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.