Jim Lu and Shane Lu DDS PLLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

10319 Issued in NC

Legal business name

JIM LU AND SHANE LU DDS PLLC

Practice address

2430 S Church St Ste B
Burlington, NC 27215

Phone

(336) 639-7101

NPI assigned

Jul 30, 2018

Organization subpart

No

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

Authorized official

Name

Dr. Jim Lu, DDS

Title

Owner

Phone

(706) 254-4191

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• Burlington Dental Doing business as

Locations

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

{
    "created_epoch": "1532908800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1532908800000",
    "number": "1346728664",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "322 S DAVIE ST APT 208",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274012856",
            "telephone_number": "706-254-4191"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2430 S CHURCH ST STE B",
            "city": "BURLINGTON",
            "state": "NC",
            "postal_code": "27215",
            "telephone_number": "336-639-7101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JIM LU AND SHANE LU DDS PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-07-30",
        "last_updated": "2018-07-30",
        "status": "A",
        "authorized_official_last_name": "LU",
        "authorized_official_first_name": "JIM",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "706-254-4191",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "NC",
            "license": "10319",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "NC",
            "license": "9969",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1922486703",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1952719353",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Burlington Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jennifer Marie Jennings, LCSWA
• Willie H. Jennings, R.PH., FASCP
• Robert E. Jepko, D.D.S.
• Patrick Jernigan, PHARMD
• Charles Kirk Jessup, M.D.
• JMMJ, LLC
• Joe K Harris Jr DDS
• Bryan Niles Johnson, DDS
• Christiana Johnson
• David S Johnson, M.D.

• General Practice Dentistry in Burlington, NC
• Providers in Burlington, NC by specialty
• General Practice Dentistry in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.