Healthcare Provider Details

I. General information

NPI: 1174427769
Provider Name (Legal Business Name): B S JU DDS PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/06/2026
Last Update Date: 10/06/2026
Certification Date: 10/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2302 S UNION AVE STE A2
TACOMA WA
98405-1332
US

IV. Provider business mailing address

2302 S UNION AVE STE A2
TACOMA WA
98405-1332
US

V. Phone/Fax

Practice location:
  • Phone: 253-752-5933
  • Fax: 253-752-6535
Mailing address:
  • Phone: 253-752-5933
  • Fax: 253-752-6535

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number
License Number StateNULL

VIII. Authorized Official

Name: BANSUK JU
Title or Position: OWNER
Credential: DDS
Phone: 253-752-5933