Pu Yu Su

Primary specialty

DentistTaxonomy code 122300000X

License

61673321 Issued in WA

Practice address

5723 NE Bothell Way Ste a
Kenmore, WA 98028-9404

Phone

(206) 525-2813

NPI assigned

Aug 6, 2019

Last updated

May 7, 2025By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Anthony a Santorsola, DDS

  • General Practice Dentistry
  • Kenmore, WA
  • NPI 1508169798
  NPD (past)
• Quirt, Mongrain, Gibree, P.C.

  dba Kenmore Dentistry

  • General Practice Dentistry
  • Kenmore, WA
  • NPI 1336630615
  NPD (past)
• Arizona Dental Professionals, P.C.

  dba Dental Village - Marana

  • General Practice Dentistry
  • Tucson, AZ
  • NPI 1306249792
  NPD (past)

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

{
    "created_epoch": "1565049600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1746576000000",
    "number": "1720633837",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5723 NE BOTHELL WAY STE A",
            "city": "KENMORE",
            "state": "WA",
            "postal_code": "980289404",
            "telephone_number": "206-525-2813"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5723 NE BOTHELL WAY STE A",
            "city": "KENMORE",
            "state": "WA",
            "postal_code": "980289404",
            "telephone_number": "206-525-2813"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SU",
        "first_name": "PU YU",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-08-06",
        "last_updated": "2025-05-07",
        "certification_date": "2025-05-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "AZ",
            "license": "D010409",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WA",
            "license": "61673321",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sober Empowerment Foundation
• Sound Point Services LLC (Sound Point Acupuncture)
• Patricia Jo Sparks, MD
• Katie Stecks
• Steven G Colwell (Southshore Rehab)
• Xueling Sun
• Mayumi Suzuki
• Melissa Swanson
• Amin Tabatabaian
• Eliazabeth A Tafesse

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2025; 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.