Provider Demographics
NPI:1013146034
Name:UENO, STEPHANI DUNG (DMD)
Entity type:Individual
Prefix:DR
First Name:STEPHANI
Middle Name:DUNG
Last Name:UENO
Suffix:
Gender:
Credentials:DMD
Other - Prefix:
Other - First Name:DUNG
Other - Middle Name:
Other - Last Name:NGUYEN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:2160 S BASCOM AVE STE 1
Mailing Address - Street 2:
Mailing Address - City:CAMPBELL
Mailing Address - State:CA
Mailing Address - Zip Code:95008-3297
Mailing Address - Country:US
Mailing Address - Phone:408-371-7616
Mailing Address - Fax:
Practice Address - Street 1:2160 S BASCOM AVE STE 1
Practice Address - Street 2:
Practice Address - City:CAMPBELL
Practice Address - State:CA
Practice Address - Zip Code:95008-3297
Practice Address - Country:US
Practice Address - Phone:408-371-7616
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-07-12
Last Update Date:2025-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA584091223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice