Provider Demographics
NPI:1982233037
Name:ANA FUSU DDS, PLLC
Entity Type:Organization
Organization Name:ANA FUSU DDS, PLLC
Other - Org Name:SMILE DENTAL CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DOCTOR/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ANA
Authorized Official - Middle Name:
Authorized Official - Last Name:FUSU
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:206-244-5187
Mailing Address - Street 1:16218 42ND AVE S
Mailing Address - Street 2:
Mailing Address - City:TUKWILA
Mailing Address - State:WA
Mailing Address - Zip Code:98188-3013
Mailing Address - Country:US
Mailing Address - Phone:206-244-5187
Mailing Address - Fax:206-248-5292
Practice Address - Street 1:16218 42ND AVE S
Practice Address - Street 2:
Practice Address - City:TUKWILA
Practice Address - State:WA
Practice Address - Zip Code:98188-3013
Practice Address - Country:US
Practice Address - Phone:206-244-5187
Practice Address - Fax:206-248-5292
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-04-01
Last Update Date:2022-07-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental