Individual provider Active NPI

John Lu, DMD

  • Periodontics
  • Lawrenceville, NJ
National Provider Identifier
1790901551
Registry record updated Feb 5, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
PeriodonticsTaxonomy code 1223P0300X
License
DI018344 Issued in NJ
Practice address
133 Franklin Corner Rd
Lawrenceville, NJ 08648
Phone
(609) 896-0700
Fax
(856) 546-2993
NPI assigned
Apr 18, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 5, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Periodontics 1223P0300X DI018344 NJ Primary

Addresses

Primary practice location

133 Franklin Corner Rd
Lawrenceville, NJ 08648

Mailing address

133 Franklin Corner Rd
Lawrenceville, NJ 08648
Phone (609) 896-0700

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.
Opted out of Medicare
Yes, effective Dec 22, 2015 through Dec 22, 2027

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
DI018344NJMDPeriodontist

NPI Registry JSON

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

{
    "created_epoch": "1176854400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1612483200000",
    "number": "1790901551",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "133 FRANKLIN CORNER RD",
            "city": "LAWRENCEVILLE",
            "state": "NJ",
            "postal_code": "08648",
            "telephone_number": "609-896-0700",
            "fax_number": "856-546-2993"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "133 FRANKLIN CORNER RD",
            "city": "LAWRENCEVILLE",
            "state": "NJ",
            "postal_code": "08648",
            "telephone_number": "609-896-0700",
            "fax_number": "856-546-2993"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LU",
        "first_name": "JOHN",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-18",
        "last_updated": "2021-02-05",
        "certification_date": "2021-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "NJ",
            "license": "DI018344",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lawrenceville, NJ

Sources for this page

Verify at the official NPI Registry.