Active NPI
Jarom N Luu, DDS
- Oral and Maxillofacial Surgery (Dentist)
- Seattle, WA
National Provider Identifier
1750473005
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Oral and Maxillofacial Surgery (Dentist)
- License
- DR20000177
- Practice address
- 1959 NE Pacific St
C-212, Box 356340
Seattle, WA 98195-6340 - Phone
- (206) 543-0065
- NPI assigned
- Sep 28, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Oral and Maxillofacial Surgery (Dentist) | 1223S0112X | DR20000177 | WA | Primary |
Addresses
Primary practice location
1959 NE Pacific St
C-212, Box 356340
Seattle, WA 98195-6340
Mailing address
526 S Tonopah Dr
Ste. 200
Las Vegas, NV 89106-4043
Phone (702) 291-2031
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1588896740 | Medicaid | NV |
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DR20000177 | WA | MD | Oral and Maxillofacial Surgery (Dentist) |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159401600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1465948800000",
"number": "1750473005",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "526 S TONOPAH DR",
"address_2": "STE. 200",
"city": "LAS VEGAS",
"state": "NV",
"postal_code": "891064043",
"telephone_number": "702-291-2031",
"fax_number": "702-366-1483"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1959 NE PACIFIC ST",
"address_2": "C-212, BOX 356340",
"city": "SEATTLE",
"state": "WA",
"postal_code": "981956340",
"telephone_number": "206-543-0065"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LUU",
"first_name": "JAROM",
"middle_name": "N",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-09-28",
"last_updated": "2016-06-15",
"status": "A"
},
"taxonomies": [
{
"code": "1223S0112X",
"taxonomy_group": "",
"desc": "Dentist, Oral and Maxillofacial Surgery",
"state": "WA",
"license": "DR20000177",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1588896740",
"state": "NV"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Seattle, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.