Individual provider Active NPI

Judy Trinh Luu, DMD

  • Dentist
  • Tampa, FL
National Provider Identifier
1720208648
Registry record updated Dec 7, 2016
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Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DN19665 Issued in FL
Practice address
12813 N Dale Mabry Hwy
Tampa, FL 33618-2803
Phone
(813) 280-0687
NPI assigned
Apr 26, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 7, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DN19665 FL Primary

Addresses

Primary practice location

12813 N Dale Mabry Hwy
Tampa, FL 33618-2803

Mailing address

449 S 12TH St
Unit 2802
Tampa, FL 33602-5606

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20150724011303 CA Order and Referring Only - DentistPractitioner - Dentist 0749593374

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Networks

  • Freedom Health HMO Network

NPI Registry JSON

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

{
    "created_epoch": "1177545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1481068800000",
    "number": "1720208648",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "449 S 12TH ST",
            "address_2": "UNIT 2802",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336025606"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12813 N DALE MABRY HWY",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336182803",
            "telephone_number": "813-280-0687"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUU",
        "first_name": "JUDY",
        "middle_name": "TRINH",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-26",
        "last_updated": "2016-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "FL",
            "license": "DN19665",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

Verify at the official NPI Registry.