Provider Demographics
NPI:1508952839
Name:YU, DUAN (DDS)
Entity Type:Individual
Prefix:DR
First Name:DUAN
Middle Name:
Last Name:YU
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 1:1908 SEABREEZE ST
Mailing Address - Street 2:
Mailing Address - City:THOUSAND OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:91320-6570
Mailing Address - Country:US
Mailing Address - Phone:310-254-8561
Mailing Address - Fax:
Practice Address - Street 1:449 W 5TH ST
Practice Address - Street 2:
Practice Address - City:OXNARD
Practice Address - State:CA
Practice Address - Zip Code:93030-7049
Practice Address - Country:US
Practice Address - Phone:805-483-6006
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-05
Last Update Date:2014-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA53962122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist