Individual provider Active NPI

Tiffany Lu, DMD, MS

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • San Diego, CA
National Provider Identifier
1376294009
Registry record updated Dec 30, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
License
DDS104630 Issued in CA
Practice address
7189 Navajo Rd Ste a
San Diego, CA 92119-1642
Phone
(619) 741-1500
NPI assigned
Jan 13, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 30, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X DDS104630 CA Primary

Addresses

Primary practice location

7189 Navajo Rd Ste a
San Diego, CA 92119-1642

Mailing address

3200 Paseo Village Way
San Diego, CA 92130-3209

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
DDS104630CAMDOrthodontics and Dentofacial Orthopedic Dentist

Practice roles

OrganizationSpecialtyStatusNew patients
Harjot Chawla DDS Inc. CurrentSince Jun 30, 2024 Accepting new patients
I Zak DDS Prof Dental Corp Orthodontics and Dentofacial Orthopedics PastSince Apr 3, 2022 Accepting new patients
Pokala Chawla Dental Partnership PastSince Jan 1, 2023 Accepting new patients
I Zak DDS Prof Dental Corp PastSince Jan 1, 2022 Accepting new patients

Locations

7189 Navajo Rd
Ste A
San Diego, CA 92119
Phone (619) 741-1500

Organizations & group practices 4

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": "1642032000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1672358400000",
    "number": "1376294009",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3200 PASEO VILLAGE WAY",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921303209"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7189 NAVAJO RD STE A",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921191642",
            "telephone_number": "619-741-1500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LU",
        "first_name": "TIFFANY",
        "name_prefix": "Dr.",
        "credential": "DMD, MS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-01-13",
        "last_updated": "2022-12-30",
        "certification_date": "2022-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "CA",
            "license": "DDS104630",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2022; 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.