Weizhong Su, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

56968 Issued in CA

Practice address

5567 N Azusa Ave
Azusa, CA 91702-5544

Phone

(626) 969-7717

Fax

(626) 633-0800

NPI assigned

May 16, 2008

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Weizhong Su DDS Inc

  • General Practice Dentistry
  • Azusa, CA
  • NPI 1477873073
  NPD (past) Authorized official

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

{
    "created_epoch": "1210896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1267056000000",
    "number": "1386801405",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5567 N AZUSA AVE",
            "city": "AZUSA",
            "state": "CA",
            "postal_code": "917025544",
            "telephone_number": "626-969-7717"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5567 N AZUSA AVE",
            "city": "AZUSA",
            "state": "CA",
            "postal_code": "917025544",
            "telephone_number": "626-969-7717",
            "fax_number": "626-633-0800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SU",
        "first_name": "WEIZHONG",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-05-16",
        "last_updated": "2010-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "56968",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE NUMBER",
            "identifier": "56968",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Linda Weiching Tang-Lin, PHARMD
• Roderic J Tate

• General Practice Dentistry in Azusa, CA
• Providers in Azusa, CA by specialty
• General Practice Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2010; 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.