Active NPI
Monique Luu
- Pediatric Dentistry
- Marysville, WA
National Provider Identifier
1942741053
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Dentistry
- License
- DE61349990
- Practice address
- 4124 80TH St NE Ste a
Marysville, WA 98270-3421 - Phone
- (360) 386-9157
- NPI assigned
- Mar 9, 2017
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Pediatric Dentistry | 1223P0221X | DE61349990 | WA | Primary |
Addresses
Primary practice location
4124 80TH St NE Ste a
Marysville, WA 98270-3421
Mailing address
4124 80TH St NE Ste a
Marysville, WA 98270-3421
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20170705000720 | IL | Order and Referring Only - Other (Physician) | 2264701325 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DE61349990 | WA | MD | Pediatric Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1489017600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1723420800000",
"number": "1942741053",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4124 80TH ST NE STE A",
"city": "MARYSVILLE",
"state": "WA",
"postal_code": "982703421"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4124 80TH ST NE STE A",
"city": "MARYSVILLE",
"state": "WA",
"postal_code": "982703421",
"telephone_number": "360-386-9157"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LUU",
"first_name": "MONIQUE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-03-09",
"last_updated": "2024-08-12",
"certification_date": "2024-08-12",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0221X",
"taxonomy_group": "",
"desc": "Dentist, Pediatric Dentistry",
"state": "WA",
"license": "DE61349990",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Marysville, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.