Provider Demographics
NPI:1013238526
Name:YU, CLAUDINE ANN D (DDS)
Entity Type:Individual
Prefix:DR
First Name:CLAUDINE ANN
Middle Name:D
Last Name:YU
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 1:4455 CENTRAL WAY
Mailing Address - Street 2:SUITE A
Mailing Address - City:FAIRFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:94534
Mailing Address - Country:US
Mailing Address - Phone:707-863-0777
Mailing Address - Fax:707-863-0700
Practice Address - Street 1:4455 CENTRAL WAY
Practice Address - Street 2:SUITE A
Practice Address - City:FAIRFIELD
Practice Address - State:CA
Practice Address - Zip Code:94534
Practice Address - Country:US
Practice Address - Phone:707-863-0777
Practice Address - Fax:707-863-0700
Is Sole Proprietor?:No
Enumeration Date:2010-06-18
Last Update Date:2012-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA572991223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice