Provider Demographics
NPI:1770795510
Name:FU, WENSHIUNG (DMD)
Entity type:Individual
Prefix:
First Name:WENSHIUNG
Middle Name:
Last Name:FU
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3405 SANMAUR CT
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40502-3814
Mailing Address - Country:US
Mailing Address - Phone:859-266-3728
Mailing Address - Fax:
Practice Address - Street 1:30 COURT STREET
Practice Address - Street 2:
Practice Address - City:ALLEN
Practice Address - State:KY
Practice Address - Zip Code:41601
Practice Address - Country:US
Practice Address - Phone:606-874-2020
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY50131223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice