Provider Demographics
NPI:1154817054
Name:SYLVANIA SAI-FAN YU DDS, INC
Entity Type:Organization
Organization Name:SYLVANIA SAI-FAN YU DDS, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SAI FAN
Authorized Official - Middle Name:
Authorized Official - Last Name:YU
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:415-608-0021
Mailing Address - Street 1:1801 TULLY RD STE D1
Mailing Address - Street 2:
Mailing Address - City:MODESTO
Mailing Address - State:CA
Mailing Address - Zip Code:95350-2937
Mailing Address - Country:US
Mailing Address - Phone:209-526-9430
Mailing Address - Fax:
Practice Address - Street 1:1801 TULLY RD STE D1
Practice Address - Street 2:
Practice Address - City:MODESTO
Practice Address - State:CA
Practice Address - Zip Code:95350-2937
Practice Address - Country:US
Practice Address - Phone:209-526-9430
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-07-03
Last Update Date:2018-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA57751261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental