Individual provider Active NPI

Dianne Luu, DMD

  • Prosthodontics
  • Fresno, CA
National Provider Identifier
1396307518
Registry record updated Feb 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
ProsthodonticsTaxonomy code 1223P0700X
License
108551 Issued in CA
Practice address
7600 N Palm Ave Ste 102
Fresno, CA 93711-5520
Phone
(559) 710-2452
NPI assigned
Jul 9, 2019
Last updated
Feb 1, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 1, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X DN1858426 MA
Prosthodontics 1223P0700X 108551 CA Primary

Addresses

Primary practice location

7600 N Palm Ave Ste 102
Fresno, CA 93711-5520

Mailing address

7600 N Palm Ave Ste 102
Fresno, CA 93711-5520
Phone (559) 710-2452

Other practice location 1

188 Longwood Ave
Boston, MA 02115-5819
Phone (617) 432-1434

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
DN1858426MAMDOrthodontics and Dentofacial Orthopedic Dentist

NPI Registry JSON

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

{
    "created_epoch": "1562630400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706745600000",
    "number": "1396307518",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7600 N PALM AVE STE 102",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937115520",
            "telephone_number": "559-710-2452"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7600 N PALM AVE STE 102",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937115520",
            "telephone_number": "559-710-2452"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "188 Longwood Ave",
            "address_purpose": "LOCATION",
            "city": "Boston",
            "state": "MA",
            "postal_code": "021155819",
            "country_code": "US",
            "telephone_number": "617-432-1434",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LUU",
        "first_name": "DIANNE",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-09",
        "last_updated": "2024-02-01",
        "certification_date": "2024-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "MA",
            "license": "DN1858426",
            "primary": false
        },
        {
            "code": "1223P0700X",
            "taxonomy_group": "",
            "desc": "Dentist, Prosthodontics",
            "state": "CA",
            "license": "108551",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fresno, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2024; 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.