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NPI Code Detail

MEDICARE: DR. JESSIE CHU D.M.D

MEDICARE:  DR. JESSIE  CHU  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
1122300000XDentistD.007596-CAL

General Provider Information

NPI Number : 1619327624
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JESSIE CHU D.M.D
Provider Business Mailing Address
First Line : 612 RED LANE RD
Second Line :
City : BIRMINGHAM
State : AL
Zip : 35215-8236
Country : US
Telephone Number : 205-873-1295
Fax Number :
Provider Business Practice Location Address
First Line : 612 RED LANE RD
Second Line :
City : BIRMINGHAM
State : AL
Zip : 35215-8236
Country : US
Telephone Number : 205-873-1295
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/21/2016
Last Update Date : 03/18/2026

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Directions to “ DR. JESSIE CHU D.M.D” Practice Location

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