Active NPI
Jonathan C Su, DDS
- General Practice Dentistry
- Seattle, WA
National Provider Identifier
1821150434
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 8460
- Practice address
- 1703 NW Market St
Seattle, WA 98107-5225 - Phone
- (209) 781-9204
- Fax
- (206) 781-0251
- NPI assigned
- Dec 14, 2006
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 8460 | WA | Primary |
Addresses
Primary practice location
1703 NW Market St
Seattle, WA 98107-5225
Mailing address
1703 NW Market St
Seattle, WA 98107-5225
Phone (206) 781-9204
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 8460 | WA | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1166054400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1220918400000",
"number": "1821150434",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1703 NW MARKET ST",
"city": "SEATTLE",
"state": "WA",
"postal_code": "981075225",
"telephone_number": "206-781-9204",
"fax_number": "206-781-0251"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1703 NW MARKET ST",
"city": "SEATTLE",
"state": "WA",
"postal_code": "981075225",
"telephone_number": "209-781-9204",
"fax_number": "206-781-0251"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SU",
"first_name": "JONATHAN",
"middle_name": "C",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-12-14",
"last_updated": "2008-09-09",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "WA",
"license": "8460",
"primary": true
}
],
"identifiers": [],
"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 Sep 9, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.