Provider Demographics
NPI:1891909735
Name:LU, HUNG (DDS)
Entity Type:Individual
Prefix:DR
First Name:HUNG
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 1:4686 N 1ST ST
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93726-0903
Mailing Address - Country:US
Mailing Address - Phone:559-225-8337
Mailing Address - Fax:559-225-8331
Practice Address - Street 1:4686 N 1ST ST
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93726
Practice Address - Country:US
Practice Address - Phone:559-225-8337
Practice Address - Fax:559-225-8331
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-10
Last Update Date:2018-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA447341223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice