Individual provider Active NPI

Samuel Kai Wu, D.D.S.

  • Pediatric Dentistry
  • Mission Viejo, CA
National Provider Identifier
1386771913
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
53112 Issued in CA
Practice address
26302 La Paz Rd
Suite 114
Mission Viejo, CA 92691-5313
Phone
(949) 581-5800
Fax
(949) 581-6794
NPI assigned
Feb 28, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Dentistry 1223P0221X 53112 CA Primary

Addresses

Primary practice location

26302 La Paz Rd
Suite 114
Mission Viejo, CA 92691-5313

Mailing address

26302 La Paz Rd
Suite 114
Mission Viejo, CA 92691-5313
Phone (949) 581-5800

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

State licenses

LicenseStateTypeSpecialty
53112CAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
J.D. de Lorme, D.D.S., Inc Pediatric Dentistry Past Accepting new patients

Organizations & group practices 1

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": "1172620800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1386771913",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26302 LA PAZ RD",
            "address_2": "SUITE 114",
            "city": "MISSION VIEJO",
            "state": "CA",
            "postal_code": "926915313",
            "telephone_number": "949-581-5800",
            "fax_number": "949-581-6794"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26302 LA PAZ RD",
            "address_2": "SUITE 114",
            "city": "MISSION VIEJO",
            "state": "CA",
            "postal_code": "926915313",
            "telephone_number": "949-581-5800",
            "fax_number": "949-581-6794"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WU",
        "first_name": "SAMUEL",
        "middle_name": "KAI",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-28",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "CA",
            "license": "53112",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mission Viejo, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.