Provider Demographics
NPI:1295800209
Name:JUI, VIVIAN (DMD)
Entity type:Individual
Prefix:DR
First Name:VIVIAN
Middle Name:
Last Name:JUI
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16300 SAND CANYON AVE
Mailing Address - Street 2:SUITE 701
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92618-3711
Mailing Address - Country:US
Mailing Address - Phone:949-727-4633
Mailing Address - Fax:949-727-4621
Practice Address - Street 1:16300 SAND CANYON AVE
Practice Address - Street 2:SUITE 701
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92618-3711
Practice Address - Country:US
Practice Address - Phone:949-727-4633
Practice Address - Fax:949-727-4621
Is Sole Proprietor?:No
Enumeration Date:2006-11-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA388551223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAD38855Medicare ID - Type UnspecifiedLICENSE NUMBER
CAU64180Medicare UPIN