Provider Demographics
NPI:1700025715
Name:HERNDON, JULIE A (DDS)
Entity Type:Individual
Prefix:DR
First Name:JULIE
Middle Name:A
Last Name:HERNDON
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 1:14375 SARATOGA AVE STE 100
Mailing Address - Street 2:
Mailing Address - City:SARATOGA
Mailing Address - State:CA
Mailing Address - Zip Code:95070-5978
Mailing Address - Country:US
Mailing Address - Phone:408-867-3711
Mailing Address - Fax:408-867-2653
Practice Address - Street 1:14375 SARATOGA AVE STE 100
Practice Address - Street 2:
Practice Address - City:SARATOGA
Practice Address - State:CA
Practice Address - Zip Code:95070-5978
Practice Address - Country:US
Practice Address - Phone:408-867-3711
Practice Address - Fax:408-867-2653
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-13
Last Update Date:2009-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA396491223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice