Bansuk Ju, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

60762065 Issued in WA

Practice address

6015 Capitol Blvd SW
Tumwater, WA 98501-5268

Phone

(360) 943-5420

NPI assigned

Jul 3, 2017

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Bansuk Ju DDS PLLC

  • Dental Clinic/Center
  • Tacoma, WA
  • NPI 1023604261
  NPD Authorized official
• Ajaipal Dhanoa PLLC

  • Dental Clinic/Center
  • Tumwater, WA
  • NPI 1255947180
  NPD (past)
• Steven L Paige DDS & Gabor Klade DDS PLLC

  • Dentist
  • Tumwater, WA
  • NPI 1124167341
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1499040000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1499040000000",
    "number": "1669993226",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1635 SW 330TH PL",
            "city": "FEDERAL WAY",
            "state": "WA",
            "postal_code": "980236432",
            "telephone_number": "213-309-1305"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6015 CAPITOL BLVD SW",
            "city": "TUMWATER",
            "state": "WA",
            "postal_code": "985015268",
            "telephone_number": "360-943-5420"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JU",
        "first_name": "BANSUK",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-07-03",
        "last_updated": "2017-07-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WA",
            "license": "60762065",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Roger James Jones, BA
• Gina Jordan, LMHCA
• Laura Jordan, CCC-SLP
• Joseph Y. de Jesus, DDS, PS
• Joseph Y. de Jesus, DDS, PS
• Juergens Chiropractic , LLC
• Christopher Juergens, D.C.
• Brenda Barrett Kabat
• Lauren Kangas
• Louise Kaplan, PHD, CRNP

• Dentist in Tumwater, WA
• Providers in Tumwater, WA by specialty
• Dentist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 3, 2017; 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.