Individual provider Active NPI

Travis David Wu, DDS

  • General Practice Dentistry
  • San Mateo, CA
National Provider Identifier
1700211000
Registry record updated Sep 5, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
62748 Issued in CA
Practice address
33 Weepingridge CT
San Mateo, CA 94402-3731
Phone
(650) 861-2285
NPI assigned
Sep 5, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 5, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 62748 CA Primary

Addresses

Primary practice location

33 Weepingridge CT
San Mateo, CA 94402-3731

Mailing address

33 Weepingridge CT
San Mateo, CA 94402-3731
Phone (650) 861-2285

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
62748CAMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1378339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1378339200000",
    "number": "1700211000",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "33 WEEPINGRIDGE CT",
            "city": "SAN MATEO",
            "state": "CA",
            "postal_code": "944023731",
            "telephone_number": "650-861-2285"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "33 WEEPINGRIDGE CT",
            "city": "SAN MATEO",
            "state": "CA",
            "postal_code": "944023731",
            "telephone_number": "650-861-2285"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WU",
        "first_name": "TRAVIS",
        "middle_name": "DAVID",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-09-05",
        "last_updated": "2013-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "62748",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Mateo, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2013; 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.