Provider Demographics
NPI:1619088168
Name:HU, JERRY CHI (DDS)
Entity Type:Individual
Prefix:DR
First Name:JERRY
Middle Name:CHI
Last Name:HU
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 1:125 N BINKLEY ST
Mailing Address - Street 2:
Mailing Address - City:SOLDOTNA
Mailing Address - State:AK
Mailing Address - Zip Code:99669-7521
Mailing Address - Country:US
Mailing Address - Phone:907-262-6466
Mailing Address - Fax:907-260-3459
Practice Address - Street 1:125 N BINKLEY ST
Practice Address - Street 2:
Practice Address - City:SOLDOTNA
Practice Address - State:AK
Practice Address - Zip Code:99669-7521
Practice Address - Country:US
Practice Address - Phone:907-262-6466
Practice Address - Fax:907-260-3459
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2023-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV7608122300000X
AK959122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist