Provider Demographics
NPI:1831299718
Name:GU, JIUPING (DDS)
Entity Type:Individual
Prefix:
First Name:JIUPING
Middle Name:
Last Name:GU
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 1:215 W HUNTER LN
Mailing Address - Street 2:
Mailing Address - City:FREMONT
Mailing Address - State:CA
Mailing Address - Zip Code:94539-6339
Mailing Address - Country:US
Mailing Address - Phone:510-770-9548
Mailing Address - Fax:510-252-0648
Practice Address - Street 1:1465 LANDESS AVE
Practice Address - Street 2:
Practice Address - City:MILPITAS
Practice Address - State:CA
Practice Address - Zip Code:95035-6953
Practice Address - Country:US
Practice Address - Phone:408-946-0902
Practice Address - Fax:408-946-1782
Is Sole Proprietor?:No
Enumeration Date:2006-09-22
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA421531223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAB42153Medicaid