Provider Demographics
NPI:1093255093
Name:TSJ KU PLLC
Entity Type:Organization
Organization Name:TSJ KU PLLC
Other - Org Name:W PLUS DENTAL OF WASHINGTON D.C.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TAE SUNG
Authorized Official - Middle Name:JOHN
Authorized Official - Last Name:KU
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:213-248-0886
Mailing Address - Street 1:2311 M ST NW
Mailing Address - Street 2:SUITE 305
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20037-1445
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2311 M ST NW
Practice Address - Street 2:SUITE 305
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20037-1445
Practice Address - Country:US
Practice Address - Phone:202-419-7587
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-24
Last Update Date:2017-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental