Individual provider Active NPI

Laura Tsu

  • Dentist
  • San Marcos, TX
National Provider Identifier
1659897056
Registry record updated Feb 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
36766 Issued in TX
Practice address
200 Springtown Way Ste 108
San Marcos, TX 78666-3856
Phone
(512) 717-6053
NPI assigned
Aug 17, 2017
Last updated
Feb 21, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 21, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 36766 TX Primary
Dentist 122300000X 101858 CA

Addresses

Primary practice location

200 Springtown Way Ste 108
San Marcos, TX 78666-3856

Mailing address

1324 S Donna Beth Ave
West Covina, CA 91791-3923

Other practice location 1

8338 N Loop 1604 W Ste 104
San Antonio, TX 78249-3482
Phone (210) 877-9100

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

LicenseStateTypeSpecialty
101858CAMDDentist
36766TXMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Ideal Dental of San Marcos PLLC Dentist CurrentSince May 21, 2023 Accepting new patients
Ideal Dental of Road Runner PLLC Dentist Past Accepting new patients

Locations

200 Springtown Way
Ste 108
San Marcos, TX 78666
Phone (512) 717-6053

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": "1502928000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1645401600000",
    "number": "1659897056",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1324 S DONNA BETH AVE",
            "city": "WEST COVINA",
            "state": "CA",
            "postal_code": "917913923"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 SPRINGTOWN WAY STE 108",
            "city": "SAN MARCOS",
            "state": "TX",
            "postal_code": "786663856",
            "telephone_number": "512-717-6053"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8338 N Loop 1604 W Ste 104",
            "address_purpose": "LOCATION",
            "city": "San Antonio",
            "state": "TX",
            "postal_code": "782493482",
            "country_code": "US",
            "telephone_number": "210-877-9100",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TSU",
        "first_name": "LAURA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-08-17",
        "last_updated": "2022-02-21",
        "certification_date": "2022-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TX",
            "license": "36766",
            "primary": true
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "101858",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Marcos, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.