Provider Demographics
NPI:1376606954
Name:YULIONGSIU, REY QUIJANO (DDS)
Entity Type:Individual
Prefix:DR
First Name:REY
Middle Name:QUIJANO
Last Name:YULIONGSIU
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4035 N FRESNO ST STE 105
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93726-4041
Mailing Address - Country:US
Mailing Address - Phone:559-228-9300
Mailing Address - Fax:559-228-9302
Practice Address - Street 1:751 W SHAW AVE
Practice Address - Street 2:
Practice Address - City:CLOVIS
Practice Address - State:CA
Practice Address - Zip Code:93612-3217
Practice Address - Country:US
Practice Address - Phone:559-323-5500
Practice Address - Fax:559-323-0130
Is Sole Proprietor?:No
Enumeration Date:2006-12-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA461581223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice