Provider Demographics
NPI:1609259290
Name:ROE, JU K (DDS)
Entity Type:Individual
Prefix:DR
First Name:JU
Middle Name:K
Last Name:ROE
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13675 37TH AVE
Mailing Address - Street 2:
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11354-4110
Mailing Address - Country:US
Mailing Address - Phone:718-539-0870
Mailing Address - Fax:
Practice Address - Street 1:30 E 60TH ST RM 401
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10022-1035
Practice Address - Country:US
Practice Address - Phone:917-657-7381
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-07-01
Last Update Date:2019-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY058496122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist