Provider Demographics
NPI:1619185972
Name:VO, JENNIFER TRAN (DMD)
Entity Type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:TRAN
Last Name:VO
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 1:171 BRANHAM LN
Mailing Address - Street 2:SUITE #9
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95136-2378
Mailing Address - Country:US
Mailing Address - Phone:408-229-6199
Mailing Address - Fax:
Practice Address - Street 1:171 BRANHAM LN
Practice Address - Street 2:SUITE #9
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95136-2378
Practice Address - Country:US
Practice Address - Phone:408-229-6199
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA53886122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAD53886Medicare ID - Type UnspecifiedMEDICAL PROVIDER NUMBER