Individual provider Active NPI

Jerry CHI Hu, DDS

  • Dentist
  • Soldotna, AK
National Provider Identifier
1619088168
Registry record updated Mar 16, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
959 Issued in AK
Practice address
125 N Binkley St
Soldotna, AK 99669-7521
Phone
(907) 262-6466
Fax
(907) 260-3459
NPI assigned
Aug 31, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 16, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 7608 NV
Dentist 122300000X 959 AK Primary

Addresses

Primary practice location

125 N Binkley St
Soldotna, AK 99669-7521

Mailing address

125 N Binkley St
Soldotna, AK 99669-7521
Phone (907) 262-6466

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV
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
I20230518002042 NV Practitioner - Dentist 7517147747 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dentist
Education
University of Michigan School of Dentistry, 1998
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

880 Seven Hills Dr
Suite 180
Henderson, NV 89052-4380
Phone (702) 478-8869

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
959AKMDPharmacist
7608NVMDChild & Adolescent Psychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
South Gate Cosmetic & Implant Dentistry LLC Dentist Current Accepting new patients
Smiles of Alaska LLC Dentist CurrentSince Nov 16, 2010 Accepting new patients
Smiles of Alaska LLC Dentist Past Accepting new patients

Locations

125 N Binkley St
Soldotna, AK 99669
Phone (907) 262-6466

880 Seven Hills Dr
Ste 180
Henderson, NV 89052
Phone (702) 478-8869

Organizations & group practices 3

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": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678924800000",
    "number": "1619088168",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "125 N BINKLEY ST",
            "city": "SOLDOTNA",
            "state": "AK",
            "postal_code": "996697521",
            "telephone_number": "907-262-6466",
            "fax_number": "907-260-3459"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 N BINKLEY ST",
            "city": "SOLDOTNA",
            "state": "AK",
            "postal_code": "996697521",
            "telephone_number": "907-262-6466",
            "fax_number": "907-260-3459"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HU",
        "first_name": "JERRY",
        "middle_name": "CHI",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-31",
        "last_updated": "2023-03-16",
        "certification_date": "2022-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NV",
            "license": "7608",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "AK",
            "license": "959",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Soldotna, AK

Sources for this page

Verify at the official NPI Registry.