Provider Demographics
NPI:1033374897
Name:WANG, JEN-KUEI (PHD, DDS)
Entity Type:Individual
Prefix:DR
First Name:JEN-KUEI
Middle Name:
Last Name:WANG
Suffix:
Gender:M
Credentials:PHD, DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1286 KIFER RD STE 111
Mailing Address - Street 2:
Mailing Address - City:SUNNYVALE
Mailing Address - State:CA
Mailing Address - Zip Code:94086-5325
Mailing Address - Country:US
Mailing Address - Phone:408-245-8822
Mailing Address - Fax:408-245-8823
Practice Address - Street 1:1286 KIFER RD STE 111
Practice Address - Street 2:
Practice Address - City:SUNNYVALE
Practice Address - State:CA
Practice Address - Zip Code:94086-5325
Practice Address - Country:US
Practice Address - Phone:408-245-8822
Practice Address - Fax:408-245-8823
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-22
Last Update Date:2009-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA530441223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics