Provider Demographics
NPI:1053438077
Name:JUPINA, JOAN M (DDS)
Entity type:Individual
Prefix:DR
First Name:JOAN
Middle Name:M
Last Name:JUPINA
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 1:24700 CALAROGA AVE
Mailing Address - Street 2:SUITE 101
Mailing Address - City:HAYWARD
Mailing Address - State:CA
Mailing Address - Zip Code:94545-2159
Mailing Address - Country:US
Mailing Address - Phone:510-783-1414
Mailing Address - Fax:510-783-0374
Practice Address - Street 1:24700 CALAROGA AVE
Practice Address - Street 2:SUITE 101
Practice Address - City:HAYWARD
Practice Address - State:CA
Practice Address - Zip Code:94545-2159
Practice Address - Country:US
Practice Address - Phone:510-783-1414
Practice Address - Fax:510-783-0374
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA357401223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice