Active NPI
Jason Shihyi Lu, D.M.D.
- Dentist
- Riverside, CA
National Provider Identifier
1285818666
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 48502
- Practice address
- 10168 Indiana Ave
Riverside, CA 92503-5302 - Phone
- (951) 900-4761
- NPI assigned
- Dec 20, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 48502 | CA | Primary |
Addresses
Primary practice location
10168 Indiana Ave
Riverside, CA 92503-5302
Mailing address
10168 Indiana Ave
Riverside, CA 92503-5302
Phone (951) 900-4761
Other practice location 1
20110 Broad Run Ln
Richmond, TX 77469-2781
Phone (909) 589-4069
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20150728005692 | CA | Order and Referring Only - Dentist | 0648584169 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 48502 | CA | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1198108800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1579219200000",
"number": "1285818666",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10168 INDIANA AVE",
"city": "RIVERSIDE",
"state": "CA",
"postal_code": "925035302",
"telephone_number": "951-900-4761"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10168 INDIANA AVE",
"city": "RIVERSIDE",
"state": "CA",
"postal_code": "925035302",
"telephone_number": "951-900-4761"
}
],
"practiceLocations": [
{
"address_1": "20110 Broad Run Ln",
"address_purpose": "LOCATION",
"city": "Richmond",
"state": "TX",
"postal_code": "774692781",
"country_code": "US",
"telephone_number": "909-589-4069",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "LU",
"first_name": "JASON",
"middle_name": "SHIHYI",
"name_prefix": "Dr.",
"credential": "D.M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-12-20",
"last_updated": "2020-01-17",
"certification_date": "2020-01-17",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "CA",
"license": "48502",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Riverside, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2020; 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.