Provider Demographics
NPI:1366234445
Name:LUU, GORDON (DDS)
Entity type:Individual
Prefix:
First Name:GORDON
Middle Name:
Last Name:LUU
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 1:18315 CASCADE DR STE 120
Mailing Address - Street 2:
Mailing Address - City:EDEN PRAIRIE
Mailing Address - State:MN
Mailing Address - Zip Code:55347-1190
Mailing Address - Country:US
Mailing Address - Phone:952-949-2536
Mailing Address - Fax:
Practice Address - Street 1:18315 CASCADE DR STE 120
Practice Address - Street 2:
Practice Address - City:EDEN PRAIRIE
Practice Address - State:MN
Practice Address - Zip Code:55347-1190
Practice Address - Country:US
Practice Address - Phone:952-949-2536
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-22
Last Update Date:2025-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MND152661223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice