Provider Demographics
NPI:1255149803
Name:SUSAN CHU DDS PLLC
Entity type:Organization
Organization Name:SUSAN CHU DDS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:HAN-LU
Authorized Official - Last Name:CHU
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:909-438-3879
Mailing Address - Street 1:20535 NE 37TH WAY
Mailing Address - Street 2:
Mailing Address - City:SAMMAMISH
Mailing Address - State:WA
Mailing Address - Zip Code:98074-9329
Mailing Address - Country:US
Mailing Address - Phone:909-438-3879
Mailing Address - Fax:
Practice Address - Street 1:280 HARDIE AVE SW STE 3
Practice Address - Street 2:
Practice Address - City:RENTON
Practice Address - State:WA
Practice Address - Zip Code:98057-5900
Practice Address - Country:US
Practice Address - Phone:425-430-0400
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-12-27
Last Update Date:2024-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental