Individual provider Active NPI

Jan C Hu, DDS

  • Pediatric Dentistry
  • Ann Arbor, MI
National Provider Identifier
1245363498
Registry record updated Jun 17, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
2901017619 Issued in MI
Practice address
1011 N University Ave
Ann Arbor, MI 48109-1078
Phone
(734) 647-4166
Fax
(734) 615-7294
NPI assigned
Mar 14, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2008

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 2901017619 MI
Pediatric Dentistry 1223P0221X 2901017619 MI Primary

Addresses

Primary practice location

1011 N University Ave
Ann Arbor, MI 48109-1078

Mailing address

1011 N University Ave
Ann Arbor, MI 48109-1078
Phone (734) 647-4166

Other identifiers 5

IdentifierTypeStateIssuer
2667565MedicaidOH
D176190OtherMIBCBS OF MI DENTAL
4747308MedicaidMI
4747317MedicaidMI
1958111960OtherMIBCBS OF MI MED SURGICAL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20150728004608 MI Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 6406891217

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2901017619MIMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Regents of the University of Michigan Dental Faculty Associates Dentist Past 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": "1173830400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1213660800000",
    "number": "1245363498",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1011 N UNIVERSITY AVE",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481091078",
            "telephone_number": "734-647-4166",
            "fax_number": "734-615-7294"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1011 N UNIVERSITY AVE",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481091078",
            "telephone_number": "734-647-4166",
            "fax_number": "734-615-7294"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HU",
        "first_name": "JAN",
        "middle_name": "C",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-14",
        "last_updated": "2008-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MI",
            "license": "2901017619",
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "MI",
            "license": "2901017619",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2667565",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF MI DENTAL",
            "identifier": "D176190",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4747308",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4747317",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF MI MED SURGICAL",
            "identifier": "1958111960",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ann Arbor, MI

Sources for this page

Verify at the official NPI Registry.