Provider Demographics
NPI:1942264494
Name:LI, JINFU (DDS)
Entity Type:Individual
Prefix:DR
First Name:JINFU
Middle Name:
Last Name:LI
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5610 SPRINGHOUSE DR.
Mailing Address - Street 2:APT 18
Mailing Address - City:PLEASANTON
Mailing Address - State:CA
Mailing Address - Zip Code:94588-4527
Mailing Address - Country:US
Mailing Address - Phone:925-416-7782
Mailing Address - Fax:925-416-7782
Practice Address - Street 1:5610 SPRINGHOUSE DR
Practice Address - Street 2:APT 18
Practice Address - City:PLEASANTON
Practice Address - State:CA
Practice Address - Zip Code:94588-4527
Practice Address - Country:US
Practice Address - Phone:925-416-7782
Practice Address - Fax:925-416-7782
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA486351223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice