Active NPI
Gary W Chu, DDS
- Orthodontics and Dentofacial Orthopedics Dentistry
- Mount Pleasant, WI
National Provider Identifier
1487920930
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthodontics and Dentofacial Orthopedics Dentistry
- License
- 3622
- Practice address
- 1130 Sunnyslope Dr
Mount Pleasant, WI 53406-3953 - Phone
- (262) 884-0255
- NPI assigned
- Mar 29, 2012
- 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 |
|---|---|---|---|---|
| Orthodontics and Dentofacial Orthopedics Dentistry | 1223X0400X | 3622 | IA | Primary |
Addresses
Primary practice location
1130 Sunnyslope Dr
Mount Pleasant, WI 53406-3953
Mailing address
1400 Valley View Dr
Mount Pleasant, WI 53405-1743
Phone (262) 994-4126
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 |
|---|---|---|---|
| 3622 | IA | MD | Orthodontics and Dentofacial Orthopedic Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1332979200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1332979200000",
"number": "1487920930",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1400 VALLEY VIEW DR",
"city": "MOUNT PLEASANT",
"state": "WI",
"postal_code": "534051743",
"telephone_number": "262-994-4126"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1130 SUNNYSLOPE DR",
"city": "MOUNT PLEASANT",
"state": "WI",
"postal_code": "534063953",
"telephone_number": "262-884-0255"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHU",
"first_name": "GARY",
"middle_name": "W",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2012-03-29",
"last_updated": "2012-03-29",
"status": "A"
},
"taxonomies": [
{
"code": "1223X0400X",
"taxonomy_group": "",
"desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
"state": "IA",
"license": "3622",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mount Pleasant, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.