Provider Demographics
NPI:1851500243
Name:CLAUDIO, VICENTA CLEOFE (DDS)
Entity Type:Individual
Prefix:DR
First Name:VICENTA
Middle Name:CLEOFE
Last Name:CLAUDIO
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 1:1154 N CAPITOL AVE
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95132-2522
Mailing Address - Country:US
Mailing Address - Phone:510-305-5247
Mailing Address - Fax:
Practice Address - Street 1:1154 N CAPITOL AVE
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95132-2522
Practice Address - Country:US
Practice Address - Phone:408-259-9000
Practice Address - Fax:408-259-9085
Is Sole Proprietor?:No
Enumeration Date:2007-05-22
Last Update Date:2007-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA431301223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice