1609939701 NPI number — ARTHUR J W WU DDS

Table of content: ARTHUR J W WU DDS (NPI 1609939701)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1609939701 NPI number — ARTHUR J W WU DDS

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
WU
Provider First Name:
ARTHUR
Provider Middle Name:
J W
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
DDS
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1609939701
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
20833 VALLEY BLVD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
WALNUT
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
91789
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
909-595-7773
Provider Business Mailing Address Fax Number:
909-595-0256

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
20833 VALLEY BLVD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WALNUT
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
91789
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
909-595-7773
Provider Business Practice Location Address Fax Number:
909-595-0256
Provider Enumeration Date:
12/19/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 122300000X , with the licence number:  DY035062 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: B3506202 . This is a "DENTI CAL" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".
  • Identifier: B3506201 . This is a "HEALTHY FAMILIES DELTA" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".




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