Individual provider Active NPI

Jessie Chu, D.M.D

  • Dentist
  • Birmingham, AL
National Provider Identifier
1619327624
Registry record updated Mar 18, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
D.007596-C Issued in AL
Practice address
612 Red Lane Rd
Birmingham, AL 35215-8236
Phone
(205) 873-1295
NPI assigned
Jun 21, 2016
Last updated
Mar 18, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 18, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X D.007596-C AL Primary

Addresses

Primary practice location

612 Red Lane Rd
Birmingham, AL 35215-8236

Mailing address

612 Red Lane Rd
Birmingham, AL 35215-8236
Phone (205) 873-1295

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20171024001207 GA Order and Referring Only - DentistPractitioner - Dentist 3870869613

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
D.007596-CALMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Jessie Chu DMD LLC Dentist Current Accepting new patients

Locations

612 Red Lane Rd
Birmingham, AL 35215
Phone (205) 833-5405

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": "1466467200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1773792000000",
    "number": "1619327624",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "612 RED LANE RD",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352158236",
            "telephone_number": "205-873-1295"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "612 RED LANE RD",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352158236",
            "telephone_number": "205-873-1295"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHU",
        "first_name": "JESSIE",
        "name_prefix": "Dr.",
        "credential": "D.M.D",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-06-21",
        "last_updated": "2026-03-18",
        "certification_date": "2026-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "AL",
            "license": "D.007596-C",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Birmingham, AL

Sources for this page

Verify at the official NPI Registry.