Provider Demographics
NPI:1801788930
Name:SHU, EMILY KATHERINE (DDS)
Entity type:Individual
Prefix:DR
First Name:EMILY
Middle Name:KATHERINE
Last Name:SHU
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4408 HERON LAKES DR
Mailing Address - Street 2:
Mailing Address - City:STOCKTON
Mailing Address - State:CA
Mailing Address - Zip Code:95219-1764
Mailing Address - Country:US
Mailing Address - Phone:909-754-2109
Mailing Address - Fax:
Practice Address - Street 1:4408 HERON LAKES DR
Practice Address - Street 2:
Practice Address - City:STOCKTON
Practice Address - State:CA
Practice Address - Zip Code:95219-1764
Practice Address - Country:US
Practice Address - Phone:909-754-2109
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-15
Last Update Date:2025-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA111871122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist