Provider Demographics
NPI:1497863286
Name:KUO, JANE YI-JEN (DDS)
Entity Type:Individual
Prefix:DR
First Name:JANE
Middle Name:YI-JEN
Last Name:KUO
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1757 BLOSSOM HILL RD
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95124-6212
Mailing Address - Country:US
Mailing Address - Phone:408-356-0800
Mailing Address - Fax:
Practice Address - Street 1:1757 BLOSSOM HILL RD
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95124-6212
Practice Address - Country:US
Practice Address - Phone:408-356-0800
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-29
Last Update Date:2008-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA502961223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice