Healthcare Provider Details

I. General information

NPI: 1770349441
Provider Name (Legal Business Name): ZHENYING LU
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/21/2024
Last Update Date: 08/23/2026
Certification Date: 08/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1959 NE PACIFIC STREET SEATTLE
SEATTLE WA
98195-0001
US

IV. Provider business mailing address

10712 5TH AVE NE UNIT 447
SEATTLE WA
98125-7214
US

V. Phone/Fax

Practice location:
  • Phone: 206-616-6996
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License NumberDE61650962
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: