Individual provider Active NPI

Jennifer Hsu

  • General Practice Dentistry
  • Raleigh, NC
National Provider Identifier
1255914495
Registry record updated Jul 1, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
RES.004314 Issued in OH
Practice address
1201 Ridge Rd
Raleigh, NC 27607-6834
Phone
(919) 828-9495
NPI assigned
May 5, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 1, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X RES.004314 OH Primary

Addresses

Primary practice location

1201 Ridge Rd
Raleigh, NC 27607-6834

Mailing address

12450 Cleveland Rd
Garner, NC 27529-8353
Phone (919) 861-7037

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20220726001359 NC Order and Referring Only - DentistPractitioner - Dentist 8224419015

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
RES.004314OHMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Lane and Associates XX DDS PA General Practice PastSince Jul 17, 2022 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": "1620172800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1656633600000",
    "number": "1255914495",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12450 CLEVELAND RD",
            "city": "GARNER",
            "state": "NC",
            "postal_code": "275298353",
            "telephone_number": "919-861-7037"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1201 RIDGE RD",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276076834",
            "telephone_number": "919-828-9495"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HSU",
        "first_name": "JENNIFER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-05-05",
        "last_updated": "2022-07-01",
        "certification_date": "2022-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OH",
            "license": "RES.004314",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Raleigh, NC

Sources for this page

Verify at the official NPI Registry.