Active NPI
Constant E. Lu, DDS
- Dentist
- Vancouver, WA
National Provider Identifier
1932217247
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 7444
- Practice address
- 3205 NE 78TH St
Vancouver, WA 98665-0697 - Phone
- (360) 576-3570
- NPI assigned
- Aug 27, 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 |
|---|---|---|---|---|
| Dentist | 122300000X | 7444 | WA | Primary |
Addresses
Primary practice location
3205 NE 78TH St
Vancouver, WA 98665-0697
Mailing address
400 N Stonegate Dr
Washougal, WA 98671-8587
Phone (360) 844-5616
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 5026455 | Medicaid | WA |
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 |
|---|---|---|---|
| 7444 | WA | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156636800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1390348800000",
"number": "1932217247",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "400 N STONEGATE DR",
"city": "WASHOUGAL",
"state": "WA",
"postal_code": "986718587",
"telephone_number": "360-844-5616"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3205 NE 78TH ST",
"city": "VANCOUVER",
"state": "WA",
"postal_code": "986650697",
"telephone_number": "360-576-3570"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LU",
"first_name": "CONSTANT",
"middle_name": "E.",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-27",
"last_updated": "2014-01-22",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "WA",
"license": "7444",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "5026455",
"state": "WA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Vancouver, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.