MEDICARE: DR. KAREN WENLEN WU D.M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	122300000X	Dentist	7992	AZ
2	1223G0001X	General Practice Dentistry	7992	AZ

General Provider Information

NPI Number	:	1144531278
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KAREN WENLEN WU D.M.D.

Provider Business Mailing Address
First Line	:	2033 E WARNER RD
Second Line	:	SUITE 115
City	:	TEMPE
State	:	AZ
Zip	:	85284-3417
Country	:	US
Telephone Number	:	480-345-2165
Fax Number	:

Provider Business Practice Location Address
First Line	:	2033 E WARNER RD
Second Line	:	SUITE 115
City	:	TEMPE
State	:	AZ
Zip	:	85284-3417
Country	:	US
Telephone Number	:	480-345-2165
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/23/2010
Last Update Date	:	06/23/2010

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