Provider Demographics
NPI:1851589998
Name:SIONGCO, JULIE AQUINO (DDS)
Entity Type:Individual
Prefix:DR
First Name:JULIE
Middle Name:AQUINO
Last Name:SIONGCO
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 1:747 S WINCHESTER BLVD
Mailing Address - Street 2:STE. 120
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95128-2990
Mailing Address - Country:US
Mailing Address - Phone:408-246-7474
Mailing Address - Fax:408-246-7477
Practice Address - Street 1:747 S WINCHESTER BLVD
Practice Address - Street 2:STE. 120
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95128-2990
Practice Address - Country:US
Practice Address - Phone:408-246-7474
Practice Address - Fax:408-246-7477
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-12
Last Update Date:2009-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA54862122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist