Provider Demographics
NPI:1033716006
Name:LU, JASPER (DDS)
Entity Type:Individual
Prefix:DR
First Name:JASPER
Middle Name:
Last Name:LU
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4340 COLCHESTER DR
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:BC
Mailing Address - Zip Code:V7C 4R4
Mailing Address - Country:CA
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:401 NE NORTHGATE WAY
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98125-6036
Practice Address - Country:US
Practice Address - Phone:206-336-2100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-02
Last Update Date:2022-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI1002450-15122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist