Healthcare Provider Details

I. General information

NPI: 1659298784
Provider Name (Legal Business Name): AMY TU DMD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/30/2026
Last Update Date: 06/30/2026
Certification Date: 05/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4800 LAKEWOOD RANCH BLVD
BRADENTON FL
34211-4953
US

IV. Provider business mailing address

6246 SW 10TH ST
WEST MIAMI FL
33144-4902
US

V. Phone/Fax

Practice location:
  • Phone: 941-756-0690
  • Fax:
Mailing address:
  • Phone: 406-763-8115
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License NumberDN31908
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: