Provider Demographics
NPI:1326470055
Name:JAIN, USHA J (RDH)
Entity Type:Individual
Prefix:MRS
First Name:USHA
Middle Name:J
Last Name:JAIN
Suffix:
Gender:F
Credentials:RDH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10402 CHISHOLM AVE
Mailing Address - Street 2:
Mailing Address - City:CUPERTINO
Mailing Address - State:CA
Mailing Address - Zip Code:95014-1315
Mailing Address - Country:US
Mailing Address - Phone:408-517-9729
Mailing Address - Fax:
Practice Address - Street 1:10402 CHISHOLM AVE
Practice Address - Street 2:
Practice Address - City:CUPERTINO
Practice Address - State:CA
Practice Address - Zip Code:95014-1315
Practice Address - Country:US
Practice Address - Phone:408-517-9729
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-08-05
Last Update Date:2013-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA23840124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist