Individual provider Active NPI

Christopher Niu, DDS

  • Pediatric Dentistry
  • San Gabriel, CA
National Provider Identifier
1982296612
Registry record updated Aug 19, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
DDS104609 Issued in CA
Practice address
701 S San Gabriel Blvd Ste E
San Gabriel, CA 91776-2764
Phone
(625) 309-0066
NPI assigned
Feb 4, 2021
Last updated
Aug 19, 2022By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 19, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Dentistry 1223P0221X DDS104609 CA Primary

Addresses

Primary practice location

701 S San Gabriel Blvd Ste E
San Gabriel, CA 91776-2764

Mailing address

701 S San Gabriel Blvd Ste C
San Gabriel, CA 91776-2764
Phone (626) 309-0066

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

LicenseStateTypeSpecialty
DDS104609CAMDPediatric Dentist

Practice roles

OrganizationSpecialtyStatusNew patients
Christopher Niu, DDS Inc Pediatric Dentistry CurrentSince Aug 28, 2022 Accepting new patients
Shi-Lin Niu D M D Inc Pediatric Dentistry PastSince Feb 1, 2021 Accepting new patients

Locations

701 S San Gabriel Blvd
Ste C
San Gabriel, CA 91776
Phone (626) 309-0066

701 S San Gabriel Blvd
Ste E
San Gabriel, CA 91776
Phone (625) 309-0066

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1612396800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660867200000",
    "number": "1982296612",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "701 S SAN GABRIEL BLVD STE C",
            "city": "SAN GABRIEL",
            "state": "CA",
            "postal_code": "917762764",
            "telephone_number": "626-309-0066"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 S SAN GABRIEL BLVD STE E",
            "city": "SAN GABRIEL",
            "state": "CA",
            "postal_code": "917762764",
            "telephone_number": "625-309-0066"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NIU",
        "first_name": "CHRISTOPHER",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-02-04",
        "last_updated": "2022-08-19",
        "certification_date": "2022-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "CA",
            "license": "DDS104609",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Gabriel, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2022; 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.