Individual provider Active NPI

Jacquelyn Kwong Chu, DDS

  • General Practice Dentistry
  • Farmington Hills, MI
National Provider Identifier
1528180718
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
2901015337 Issued in MI
Practice address
32905 W Twelve Mile Rd
Suite #350
Farmington Hills, MI 48334
Phone
(248) 489-7008
Fax
(248) 489-7038
NPI assigned
Apr 6, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 2901015337 MI Primary

Addresses

Primary practice location

32905 W Twelve Mile Rd
Suite #350
Farmington Hills, MI 48334

Mailing address

32905 W Twelve Mile Rd
Suite #350
Farmington Hills, MI 48334
Phone (248) 489-7008

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20170111001051 MI Order and Referring Only - Other (Physician)Practitioner - Other (Physician) 6002197100

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2901015337MIMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Jacquelyn Chu D.D.S.,P.C. CurrentSince May 28, 2023 Accepting new patients

Locations

32905 W 12 Mile Rd
Ste 350
Farmington Hills, MI 48334
Phone (248) 489-7008

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1175817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1528180718",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "32905 W TWELVE MILE RD",
            "address_2": "SUITE #350",
            "city": "FARMINGTON HILLS",
            "state": "MI",
            "postal_code": "48334",
            "telephone_number": "248-489-7008",
            "fax_number": "248-489-7038"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "32905 W TWELVE MILE RD",
            "address_2": "SUITE #350",
            "city": "FARMINGTON HILLS",
            "state": "MI",
            "postal_code": "48334",
            "telephone_number": "248-489-7008",
            "fax_number": "248-489-7038"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHU",
        "first_name": "JACQUELYN",
        "middle_name": "KWONG",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-06",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "2901015337",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Farmington Hills, MI

Sources for this page

Verify at the official NPI Registry.