Active NPI
Miles Chu, DMD
- Periodontics
- Fairfield, CT
National Provider Identifier
1447564893
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Periodontics
- License
- 010248
- Practice address
- 1047 Old Post Rd
Fairfield, CT 06824-5906 - Phone
- (215) 817-5921
- NPI assigned
- Jul 27, 2010
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Periodontics | 1223P0300X | 010248 | CT | Primary |
Addresses
Primary practice location
1047 Old Post Rd
Fairfield, CT 06824-5906
Mailing address
1047 Old Post Rd
Fairfield, CT 06824-5906
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
| License | State | Type | Specialty |
|---|---|---|---|
| 010248 | CT | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1280188800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1280188800000",
"number": "1447564893",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1047 OLD POST RD",
"city": "FAIRFIELD",
"state": "CT",
"postal_code": "068245906"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1047 OLD POST RD",
"city": "FAIRFIELD",
"state": "CT",
"postal_code": "068245906",
"telephone_number": "215-817-5921"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHU",
"first_name": "MILES",
"name_prefix": "Dr.",
"credential": "DMD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2010-07-27",
"last_updated": "2010-07-27",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0300X",
"taxonomy_group": "",
"desc": "Dentist, Periodontics",
"state": "CT",
"license": "010248",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fairfield, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 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.