Provider Demographics
NPI:1881054112
Name:WU, DAN (DDS)
Entity type:Individual
Prefix:MS
First Name:DAN
Middle Name:
Last Name:WU
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 1:5200 IRON HORSE PKWY APT 353
Mailing Address - Street 2:
Mailing Address - City:DUBLIN
Mailing Address - State:CA
Mailing Address - Zip Code:94568-7113
Mailing Address - Country:US
Mailing Address - Phone:415-316-2092
Mailing Address - Fax:
Practice Address - Street 1:1855 SAN MIGUEL DR STE 31
Practice Address - Street 2:
Practice Address - City:WALNUT CREEK
Practice Address - State:CA
Practice Address - Zip Code:94596-5298
Practice Address - Country:US
Practice Address - Phone:925-935-2700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-02-29
Last Update Date:2022-07-21
Deactivation Date:2016-10-21
Deactivation Code:
Reactivation Date:2016-10-31
Provider Licenses
StateLicense IDTaxonomies
CA1016061223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice