Individual provider Active NPI

Caroline Hu, D.M.D

  • Pediatric Dentistry
  • La Crescenta, CA
National Provider Identifier
1447487798
Registry record updated Sep 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
61226 Issued in CA
Practice address
2629 Foothill Blvd
#381
La Crescenta, CA 91214-3511
Phone
(954) 547-1858
NPI assigned
Jun 14, 2009
Last updated
Sep 22, 2021By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 22, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 000085-1 NY
General Practice Dentistry 1223G0001X 055241 NY
Pediatric Dentistry 1223P0221X 61226 CA Primary

Addresses

Primary practice location

2629 Foothill Blvd
#381
La Crescenta, CA 91214-3511

Mailing address

2629 Foothill Blvd
#381
La Cresenta, CA 91214
Phone (954) 547-1858

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
I20160118000896 CA Order and Referring Only - DentistPractitioner - Dentist 8426351990

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
000085-1NYMDDentist
055241NYMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Dr. Hu, a Professional Dental Corporation Pediatric Dentistry CurrentSince May 16, 2021 Accepting new patients

Locations

120 N Grand Ave
Glendora, CA 91741
Phone (626) 788-3308

2629 Foothill Blvd
La Crescenta, CA 91214
Phone (424) 281-9781

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1244937600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632268800000",
    "number": "1447487798",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2629 FOOTHILL BLVD",
            "address_2": "#381",
            "city": "LA CRESENTA",
            "state": "CA",
            "postal_code": "91214",
            "telephone_number": "954-547-1858"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2629 FOOTHILL BLVD",
            "address_2": "#381",
            "city": "LA CRESCENTA",
            "state": "CA",
            "postal_code": "912143511",
            "telephone_number": "954-547-1858"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HU",
        "first_name": "CAROLINE",
        "credential": "D.M.D",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-06-14",
        "last_updated": "2021-09-22",
        "certification_date": "2021-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NY",
            "license": "000085-1",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "055241",
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "CA",
            "license": "61226",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in La Crescenta, CA

Sources for this page

Verify at the official NPI Registry.