Provider Demographics
NPI:1023467735
Name:YAO, YUJIA
Entity type:Individual
Prefix:
First Name:YUJIA
Middle Name:
Last Name:YAO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1670 WESTWOOD DR STE J
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95125-5111
Mailing Address - Country:US
Mailing Address - Phone:408-826-4676
Mailing Address - Fax:408-826-4554
Practice Address - Street 1:1670 WESTWOOD DR STE J
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95125-5111
Practice Address - Country:US
Practice Address - Phone:408-826-4676
Practice Address - Fax:408-826-4554
Is Sole Proprietor?:No
Enumeration Date:2016-06-03
Last Update Date:2022-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA100258122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist