Kevin Erick Wu, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

106378 Issued in CA

Practice address

520 E Manchester Ave
Los Angeles, CA 90003-3525

Phone

(213) 322-0864

NPI assigned

Jul 23, 2021

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1626998400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1627862400000",
    "number": "1790358935",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6010 SULTANA AVE",
            "city": "TEMPLE CITY",
            "state": "CA",
            "postal_code": "917801549"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "520 E MANCHESTER AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900033525",
            "telephone_number": "213-322-0864"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WU",
        "first_name": "KEVIN",
        "middle_name": "ERICK",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-07-23",
        "last_updated": "2021-08-02",
        "certification_date": "2021-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "106378",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joyce Ying-Chen Wu, M.D.
• Judy Wu
• Julie Wu
• Justine Amanda Wu, MA
• Kenneth Wu, MD
• Kristen Gale Wu, DPT
• Krystle Cher Purificacion Wu, PHARM.D.
• Margaret Wu
• Mark Wu, MD
• May Sundongmei Wu, RESP THERAPIST

• General Practice Dentistry in Los Angeles, CA
• Providers in Los Angeles, 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 Aug 2, 2021; 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.