Provider Demographics
NPI:1295803104
Name:YU, MARY ANNE MAIPID (DDM)
Entity type:Individual
Prefix:DR
First Name:MARY ANNE
Middle Name:MAIPID
Last Name:YU
Suffix:
Gender:F
Credentials:DDM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3061 MARICOTTE DR
Mailing Address - Street 2:
Mailing Address - City:PALMDALE
Mailing Address - State:CA
Mailing Address - Zip Code:93550-2438
Mailing Address - Country:US
Mailing Address - Phone:661-267-2475
Mailing Address - Fax:
Practice Address - Street 1:1253 W EL CAMINO REAL
Practice Address - Street 2:#B
Practice Address - City:SUNNYVALE
Practice Address - State:CA
Practice Address - Zip Code:94087-1062
Practice Address - Country:US
Practice Address - Phone:650-938-3000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-30
Last Update Date:2008-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA526411223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice