Provider Demographics
NPI:1518033737
Name:ISON, DAISY (DDS)
Entity Type:Individual
Prefix:DR
First Name:DAISY
Middle Name:
Last Name:ISON
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 1:2340 MCKEE RD
Mailing Address - Street 2:SUITE # 22
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95116-1615
Mailing Address - Country:US
Mailing Address - Phone:408-272-8855
Mailing Address - Fax:408-272-8858
Practice Address - Street 1:2340 MCKEE RD
Practice Address - Street 2:SUITE # 22
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95116-1615
Practice Address - Country:US
Practice Address - Phone:408-272-8855
Practice Address - Fax:408-272-8858
Is Sole Proprietor?:No
Enumeration Date:2006-11-28
Last Update Date:2014-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA341201223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAMETLIFEOtherPRIVATE INS
CADELTA DENTALOtherPRIVATE INS
CAB34120Medicare ID - Type UnspecifiedDENTI-CAL