Provider Demographics
NPI:1740689363
Name:DR WU PEDIATRIC DENTISTRY, PLLC
Entity type:Organization
Organization Name:DR WU PEDIATRIC DENTISTRY, PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JUN
Authorized Official - Middle Name:
Authorized Official - Last Name:WU
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:832-409-7168
Mailing Address - Street 1:5511 BARON RIDGE LN
Mailing Address - Street 2:
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77494-6613
Mailing Address - Country:US
Mailing Address - Phone:832-409-7168
Mailing Address - Fax:832-777-7056
Practice Address - Street 1:9750 BELLAIRE BLVD STE 250
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77036-3446
Practice Address - Country:US
Practice Address - Phone:832-409-7168
Practice Address - Fax:832-777-7056
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-08-20
Last Update Date:2014-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX270771223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0221XDental ProvidersDentistPediatric DentistryGroup - Single Specialty