Provider Demographics
NPI:1386821221
Name:YEUNG, JAMIE YUEN YIN (DMD)
Entity Type:Individual
Prefix:DR
First Name:JAMIE
Middle Name:YUEN YIN
Last Name:YEUNG
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 1:1667 DOMINICAN WAY
Mailing Address - Street 2:SUITE 232
Mailing Address - City:SANTA CRUZ
Mailing Address - State:CA
Mailing Address - Zip Code:95065-1518
Mailing Address - Country:US
Mailing Address - Phone:831-476-5512
Mailing Address - Fax:
Practice Address - Street 1:7012 SILVER MOON CT
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95120-3136
Practice Address - Country:US
Practice Address - Phone:408-323-4957
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-23
Last Update Date:2008-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA470221223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice