Individual provider Active NPI

Chao Lu, DDS

  • Orofacial Pain Dentistry
  • Boston, MA
National Provider Identifier
1669765939
Registry record updated May 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orofacial Pain DentistryTaxonomy code 1223X2210X
License
DN1858899 Issued in MA
Practice address
1 Kneeland St # 601
Boston, MA 02111-1527
Phone
(617) 636-6817
NPI assigned
May 19, 2011
Last updated
May 10, 2024By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 10, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DL11202 MA
Orofacial Pain Dentistry 1223X2210X DN1858899 MA Primary

Addresses

Primary practice location

1 Kneeland St # 601
Boston, MA 02111-1527

Mailing address

1 Kneeland St # 601
Boston, MA 02111-1527
Phone (617) 636-6817

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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
I20111102000908 MA Practitioner - DentistPractitioner - Oral Surgery 5698948834 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dentist
Education
Tufts University School of Dental Medicine, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Trustees of Tufts CollegeGroup PAC ID 3779522628, 15 clinicians

Practice addresses (Care Compare)

1 Kneeland St
Boston, MA 02111-1527
Phone (617) 636-6828

200 Harrison Ave
2CD Floor
Boston, MA 02111-1527

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DL11202MAMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Trustees of Tufts College CurrentSince Sep 1, 2011 Accepting new patients
Trustees of Tufts College Orofacial Pain CurrentSince Sep 1, 2011 Accepting new patients

Locations

1 Kneeland St
Boston, MA 02111
Phone (617) 636-6515

1 Kneeland St
#601
Boston, MA 02111
Phone (617) 636-6817

1 Kneeland St
Fl 6
Boston, MA 02111
Phone (617) 636-3932

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": "1305763200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715299200000",
    "number": "1669765939",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 KNEELAND ST # 601",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021111527",
            "telephone_number": "617-636-6817"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 KNEELAND ST # 601",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021111527",
            "telephone_number": "617-636-6817"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LU",
        "first_name": "CHAO",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-05-19",
        "last_updated": "2024-05-10",
        "certification_date": "2024-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MA",
            "license": "DL11202",
            "primary": false
        },
        {
            "code": "1223X2210X",
            "taxonomy_group": "",
            "desc": "Dentist, Orofacial Pain",
            "state": "MA",
            "license": "DN1858899",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.