Provider Demographics
NPI:1659470052
Name:HU, SERENA (DDS)
Entity Type:Individual
Prefix:DR
First Name:SERENA
Middle Name:
Last Name:HU
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 1:1040 N RENGSTORFF AVE STE A3
Mailing Address - Street 2:
Mailing Address - City:MOUNTAIN VIEW
Mailing Address - State:CA
Mailing Address - Zip Code:94043-1761
Mailing Address - Country:US
Mailing Address - Phone:650-938-3838
Mailing Address - Fax:
Practice Address - Street 1:1040 N RENGSTORFF AVE STE A3
Practice Address - Street 2:
Practice Address - City:MOUNTAIN VIEW
Practice Address - State:CA
Practice Address - Zip Code:94043-1761
Practice Address - Country:US
Practice Address - Phone:650-938-3838
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA437951223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice