Active NPI
Andy A Tu, DDS
- Dentist
- Minneapolis, MN
National Provider Identifier
1295398428
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- D14460
- Practice address
- 515 Delaware St SE
Minneapolis, MN 55455-0357 - Phone
- (612) 625-2495
- NPI assigned
- Apr 14, 2019
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Dentist | 122300000X | D14460 | MN | Primary |
Addresses
Primary practice location
515 Delaware St SE
Minneapolis, MN 55455-0357
Mailing address
425 Erie St SE Apt 201
Minneapolis, MN 55414-3042
Phone (415) 623-8102
Other practice location 1
419 Erie St SE
Minneapolis, MN 55414-3059
Phone (415) 623-8102
Other practice location 2
50 N Medical Dr
Salt Lake City, UT 84132-0001
Phone (801) 587-6453
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MN
- 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 |
|---|---|---|---|---|
| I20240507002455 | MN | Order and Referring Only - Dentist | 6204282767 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1555200000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1601856000000",
"number": "1295398428",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "425 ERIE ST SE APT 201",
"city": "MINNEAPOLIS",
"state": "MN",
"postal_code": "554143042",
"telephone_number": "415-623-8102"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "515 DELAWARE ST SE",
"city": "MINNEAPOLIS",
"state": "MN",
"postal_code": "554550357",
"telephone_number": "612-625-2495"
}
],
"practiceLocations": [
{
"address_1": "419 Erie St SE",
"address_purpose": "LOCATION",
"city": "Minneapolis",
"state": "MN",
"postal_code": "554143059",
"country_code": "US",
"telephone_number": "415-623-8102",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "50 N Medical Dr",
"address_purpose": "LOCATION",
"city": "Salt Lake City",
"state": "UT",
"postal_code": "841320001",
"country_code": "US",
"telephone_number": "801-587-6453",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "TU",
"first_name": "ANDY",
"middle_name": "A",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2019-04-14",
"last_updated": "2020-10-05",
"certification_date": "2020-10-05",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "MN",
"license": "D14460",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Minneapolis, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 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.