Individual provider Active NPI

Tristan Lue, DDS

  • Dentist
  • Flushing, NY
National Provider Identifier
1740459023
Registry record updated Dec 21, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
053141 Issued in NY
Practice address
15038 Union Tpke
Suite 12H
Flushing, NY 11367-3948
Phone
(845) 527-7772
NPI assigned
Feb 21, 2008
Last updated
Dec 21, 2011By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 21, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 053141 NY Primary

Addresses

Primary practice location

15038 Union Tpke
Suite 12H
Flushing, NY 11367-3948

Mailing address

15038 Union Tpke
Suite 12H
Flushing, NY 11367-3948
Phone (845) 527-7772

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

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": "1203552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1324425600000",
    "number": "1740459023",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15038 UNION TPKE",
            "address_2": "SUITE 12H",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113673948",
            "telephone_number": "845-527-7772"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15038 UNION TPKE",
            "address_2": "SUITE 12H",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113673948",
            "telephone_number": "845-527-7772"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUE",
        "first_name": "TRISTAN",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-02-21",
        "last_updated": "2011-12-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NY",
            "license": "053141",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Flushing, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2011; 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.