Provider Demographics
NPI:1508346818
Name:LAI AND WU DENTAL CORP
Entity Type:Organization
Organization Name:LAI AND WU DENTAL CORP
Other - Org Name:COMPASS DENTAL ARTS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DOCTOR/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:KA
Authorized Official - Middle Name:ON
Authorized Official - Last Name:LAI
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:703-507-0707
Mailing Address - Street 1:3720 N 1ST ST STE C
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95134-1717
Mailing Address - Country:US
Mailing Address - Phone:408-894-8135
Mailing Address - Fax:
Practice Address - Street 1:670 RIVER OAKS PKWY STE J
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95134-1988
Practice Address - Country:US
Practice Address - Phone:408-894-8140
Practice Address - Fax:408-894-8139
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-08-16
Last Update Date:2018-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA629701223G0001X
CA631801223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty