Lisa Ku, D.D.S.

Primary specialty

DentistTaxonomy code 122300000X

License

DE 60258242 Issued in WA

Practice address

1708 E 44TH St
Tacoma, WA 98404-4611

Phone

(253) 572-7002

Fax

(253) 593-2854

NPI assigned

Dec 29, 2006

Sex

Female

Sole proprietor

No

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)

Not enrolled

HHS exclusion list flag

CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

State licenses

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

{
    "created_epoch": "1167350400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1447286400000",
    "number": "1346306511",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1019 PACIFIC AVE",
            "address_2": "STE. 300",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984024443",
            "telephone_number": "253-597-4550",
            "fax_number": "253-597-4556"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1708 E 44TH ST",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984044611",
            "telephone_number": "253-572-7002",
            "fax_number": "253-593-2854"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KU",
        "first_name": "LISA",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-29",
        "last_updated": "2015-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "CA51866",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WA",
            "license": "DE 60258242",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sol Kryder
• Jonathan P Kryman, MD
• Samantha Jade Krysiak, RDN
• Justin Krzmarzick
• Martha Ksepka, MD
• Stephen C Ku, DO
• Martin A Kubeja, MD
• Hannah Kubicek, BA
• Stephen Peter Kubiszewski, LMHC, MAC, CEAP
• Elisabeth A. Kubo, LMP

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2015; 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.