Huan Su, D.D.S.

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

License

DE60101496 Issued in WA

Practice address

2302 S Union Ave
Building C Suite 22
Tacoma, WA 98405-1300

Phone

(253) 752-6336

NPI assigned

Sep 15, 2009

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in WA

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

Medicare enrollment (NPD)

Enrolled

Practice roles

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.

• H Todd Su DDS PLLC

  • Dentist
  • Burien, WA
  • NPI 1861748766
  Medicare reassignment Authorized official
• Karbakhsch Periodontics & Implants - South PLLC

  • Periodontics
  • Puyallup, WA
  • NPI 1639458722
  NPD (past)
• Ronald E. Harmon, D.D.S., P.S.

  • Periodontics
  • Tacoma, WA
  • NPI 1528288008
  NPD (past)
• Son and Lien Nguyen, PS

  • General Practice Dentistry
  • Burien, WA
  • NPI 1235219049
  NPD (past)

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

{
    "created_epoch": "1252972800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1252972800000",
    "number": "1194058669",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1400 LAKE WASHINGTON BLVD N",
            "address_2": "APT A302",
            "city": "RENTON",
            "state": "WA",
            "postal_code": "980562564",
            "telephone_number": "425-988-4755"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2302 S UNION AVE",
            "address_2": "BUILDING C SUITE 22",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984051300",
            "telephone_number": "253-752-6336"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SU",
        "first_name": "HUAN",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-09-15",
        "last_updated": "2009-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WA",
            "license": "DE60101496",
            "primary": false
        },
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "WA",
            "license": "DE60101496",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Orlando Stumvoll
• Jessica E.S. Sturgess, MD
• Andrea Jean Sturgill, LCSW
• Percy Sturgis
• Diane Louise Styskal, RD
• Lani Jo Su, RN
• Virginia Su, M.D.
• William W Su, M.D.
• April Su'Esu'E-Lefono
• Rachel Suaimhneas, ED.S, NCSP

• Periodontics in Tacoma, WA
• Providers in Tacoma, WA by specialty
• Periodontics in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.