Provider Demographics
NPI:1275856817
Name:YOO, JENNY (DMD)
Entity Type:Individual
Prefix:DR
First Name:JENNY
Middle Name:
Last Name:YOO
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 1:19739 VIA ESCUELA DR
Mailing Address - Street 2:
Mailing Address - City:SARATOGA
Mailing Address - State:CA
Mailing Address - Zip Code:95070-4443
Mailing Address - Country:US
Mailing Address - Phone:310-237-3645
Mailing Address - Fax:
Practice Address - Street 1:11040 BOLLINGER CANYON RD
Practice Address - Street 2:SUITE I
Practice Address - City:SAN RAMON
Practice Address - State:CA
Practice Address - Zip Code:94582-4969
Practice Address - Country:US
Practice Address - Phone:925-648-8881
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-03-10
Last Update Date:2010-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA578751223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics