Provider Demographics
NPI:1255533279
Name:LUU, JENNIFER Q (DDS)
Entity type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:Q
Last Name:LUU
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 1:398 SANDHURST DR
Mailing Address - Street 2:
Mailing Address - City:MILPITAS
Mailing Address - State:CA
Mailing Address - Zip Code:95035-4486
Mailing Address - Country:US
Mailing Address - Phone:408-934-9958
Mailing Address - Fax:
Practice Address - Street 1:2075 FOREST AVE STE 6
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95128-4812
Practice Address - Country:US
Practice Address - Phone:408-247-9291
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-01
Last Update Date:2020-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA503131223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice