Individual provider Active NPI

Ju U Lawrence, DMD

  • Pediatric Dentistry
  • Paso Robles, CA
National Provider Identifier
1356302608
Registry record updated Oct 5, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
57203 Issued in CA
Practice address
717 Walnut Dr
Paso Robles, CA 93446-2315
Phone
(805) 238-5334
NPI assigned
Mar 28, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 5, 2017

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X D5255 AZ
General Practice Dentistry 1223G0001X 7277 OR
Pediatric Dentistry 1223P0221X 57203 CA Primary

Addresses

Primary practice location

717 Walnut Dr
Paso Robles, CA 93446-2315

Mailing address

9201 N 5TH St
Phoenix, AZ 85020-2532
Phone (623) 434-3943

Other identifiers 1

IdentifierTypeStateIssuer
518011MedicaidAZ

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230822003648 CA Order and Referring Only - DentistPractitioner - Dentist 0244693356

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
D5255AZMDGeneral Practice Dentistry
7277ORMDGeneral Practice Dentistry
57203CAMDPediatric Dentist

Practice roles

OrganizationSpecialtyStatusNew patients
Partnership for the Children of San Luis Obispo Co General Practice Past Accepting new patients
Tolosa Childrens Dental Center Pediatric Dentistry Past Accepting new patients

Organizations & group practices 2

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": "1143504000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1507161600000",
    "number": "1356302608",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9201 N 5TH ST",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850202532",
            "telephone_number": "623-434-3943",
            "fax_number": "623-321-6268"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "717 WALNUT DR",
            "city": "PASO ROBLES",
            "state": "CA",
            "postal_code": "934462315",
            "telephone_number": "805-238-5334"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAWRENCE",
        "first_name": "JU",
        "middle_name": "U",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-28",
        "last_updated": "2017-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AZ",
            "license": "D5255",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OR",
            "license": "7277",
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "CA",
            "license": "57203",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "518011",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Paso Robles, CA

Sources for this page

Verify at the official NPI Registry.