Tracy Ku, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

35415 Issued in CA

Practice address

1448 S San Gabriel Blvd
San Gabriel, CA 91776-3656

Phone

(626) 288-2000

Fax

(626) 288-1402

NPI assigned

Aug 25, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1156464000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1740398353",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1448 S SAN GABRIEL BLVD",
            "city": "SAN GABRIEL",
            "state": "CA",
            "postal_code": "917763656",
            "telephone_number": "626-288-2000",
            "fax_number": "626-288-1402"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1448 S SAN GABRIEL BLVD",
            "city": "SAN GABRIEL",
            "state": "CA",
            "postal_code": "917763656",
            "telephone_number": "626-288-2000",
            "fax_number": "626-288-1402"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KU",
        "first_name": "TRACY",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-25",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "35415",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED CONCORDIA",
            "identifier": "972069",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DENTI-CAL",
            "identifier": "B35415-01",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "35415",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Golden Kong, DDS
• Joseph T. Kor, D.M.D
• Elbert Kou
• Richard Eric Kratz, MD MPH
• Ethan Kruse
• Tracy Cui Qiong Kuang, RDH
• Avtar Singh Kumar, M.D.
• Jirapan Kumlue, PTA
• David Te Fu Kuo
• Kwon Dental Group Inc

• General Practice Dentistry in San Gabriel, CA
• Providers in San Gabriel, CA by specialty
• General Practice Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.