Provider Demographics
NPI:1033830831
Name:FERDOWSIAN, YOUJIA MA (DDS)
Entity Type:Individual
Prefix:DR
First Name:YOUJIA
Middle Name:MA
Last Name:FERDOWSIAN
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:YOUJIA
Other - Middle Name:
Other - Last Name:MA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1598 WASHINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:SAN LEANDRO
Mailing Address - State:CA
Mailing Address - Zip Code:94577-4465
Mailing Address - Country:US
Mailing Address - Phone:510-545-4588
Mailing Address - Fax:
Practice Address - Street 1:1598 WASHINGTON AVE
Practice Address - Street 2:
Practice Address - City:SAN LEANDRO
Practice Address - State:CA
Practice Address - Zip Code:94577-4465
Practice Address - Country:US
Practice Address - Phone:510-545-4588
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-08
Last Update Date:2022-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1079601223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice