Provider Demographics
NPI:1265662647
Name:TAO, YUAN (DMD)
Entity Type:Individual
Prefix:DR
First Name:YUAN
Middle Name:
Last Name:TAO
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:877 W FREMONT AVE
Mailing Address - Street 2:STE C-2
Mailing Address - City:SUNNYVALE
Mailing Address - State:CA
Mailing Address - Zip Code:94087-2315
Mailing Address - Country:US
Mailing Address - Phone:408-737-2988
Mailing Address - Fax:408-737-2688
Practice Address - Street 1:877 W FREMONT AVE
Practice Address - Street 2:STE C-2
Practice Address - City:SUNNYVALE
Practice Address - State:CA
Practice Address - Zip Code:94087-2315
Practice Address - Country:US
Practice Address - Phone:408-737-2988
Practice Address - Fax:408-737-2688
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-21
Last Update Date:2011-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA584901223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice