Individual provider Active NPI

Perry Y Jue, D.M.D.

  • General Practice Dentistry
  • Bakersfield, CA
National Provider Identifier
1730523879
Registry record updated Apr 19, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
41430 Issued in CA
Practice address
5101 Commerce Dr Ste 102
Bakersfield, CA 93309-0413
Phone
(661) 323-1500
Fax
(661) 323-1767
NPI assigned
Apr 19, 2013
Last updated
Apr 19, 2013By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 19, 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 41430 CA Primary

Addresses

Primary practice location

5101 Commerce Dr Ste 102
Bakersfield, CA 93309-0413

Mailing address

5101 Commerce Dr Ste 102
Bakersfield, CA 93309-0413
Phone (661) 323-1500

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: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160602002023 CA Order and Referring Only - DentistPractitioner - General PracticePractitioner - Dentist 1759671712

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
41430CAMDPhysical Therapist

Organizations & group practices 1

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": "1366329600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1366329600000",
    "number": "1730523879",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5101 COMMERCE DR STE 102",
            "city": "BAKERSFIELD",
            "state": "CA",
            "postal_code": "933090413",
            "telephone_number": "661-323-1500",
            "fax_number": "661-323-1767"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5101 COMMERCE DR STE 102",
            "city": "BAKERSFIELD",
            "state": "CA",
            "postal_code": "933090413",
            "telephone_number": "661-323-1500",
            "fax_number": "661-323-1767"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JUE",
        "first_name": "PERRY",
        "middle_name": "Y",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-04-19",
        "last_updated": "2013-04-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "41430",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bakersfield, CA

Sources for this page

Verify at the official NPI Registry.