Individual provider Active NPI

Rosemary Wu, DMD. MS

  • Periodontics
  • Roseville, CA
National Provider Identifier
1659406205
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PeriodonticsTaxonomy code 1223P0300X
License
52483 Issued in CA
Practice address
2428 Professional Dr
Ste. 100
Roseville, CA 95661-7774
Phone
(916) 786-6585
Fax
(916) 786-7542
NPI assigned
Feb 23, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
Yes

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
Periodontics 1223P0300X 52483 CA Primary

Addresses

Primary practice location

2428 Professional Dr
Ste. 100
Roseville, CA 95661-7774

Mailing address

2428 Professional Dr
Ste. 100
Roseville, CA 95661-7774
Phone (916) 786-6585

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Previously, effective Sep 3, 2020 through Sep 3, 2026

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
52483CAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Capitol Periodontal Group Periodontics Past Accepting new patients
Capitol Periodontal Group Periodontics Past Accepting new patients

Organizations & group practices 2

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": "1172188800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1659406205",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2428 PROFESSIONAL DR",
            "address_2": "STE. 100",
            "city": "ROSEVILLE",
            "state": "CA",
            "postal_code": "956617774",
            "telephone_number": "916-786-6585",
            "fax_number": "916-786-7542"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2428 PROFESSIONAL DR",
            "address_2": "STE. 100",
            "city": "ROSEVILLE",
            "state": "CA",
            "postal_code": "956617774",
            "telephone_number": "916-786-6585",
            "fax_number": "916-786-7542"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WU",
        "first_name": "ROSEMARY",
        "name_prefix": "Dr.",
        "credential": "DMD. MS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-23",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "CA",
            "license": "52483",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roseville, CA

Sources for this page

Verify at the official NPI Registry.