Provider Demographics
NPI:1770271868
Name:WU, LUKE (DDS)
Entity type:Individual
Prefix:
First Name:LUKE
Middle Name:
Last Name:WU
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 1:6851 ROSWELL RD APT O28
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30328-2426
Mailing Address - Country:US
Mailing Address - Phone:408-905-9230
Mailing Address - Fax:
Practice Address - Street 1:11770 HAYNES BRIDGE RD STE 605
Practice Address - Street 2:
Practice Address - City:ALPHARETTA
Practice Address - State:GA
Practice Address - Zip Code:30009-1971
Practice Address - Country:US
Practice Address - Phone:678-689-0205
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-26
Last Update Date:2023-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1076561223G0001X
GADN1229991223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice