Provider Demographics
NPI:1932226719
Name:WU, TIMOTHY CHENGHSIEN (DMD)
Entity Type:Individual
Prefix:DR
First Name:TIMOTHY
Middle Name:CHENGHSIEN
Last Name:WU
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1501 CEDARWOOD DR
Mailing Address - Street 2:
Mailing Address - City:SAN MATEO
Mailing Address - State:CA
Mailing Address - Zip Code:94403-3912
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:100 W EL CAMINO REAL
Practice Address - Street 2:SUITE #76
Practice Address - City:MOUNTAIN VIEW
Practice Address - State:CA
Practice Address - Zip Code:94040-2664
Practice Address - Country:US
Practice Address - Phone:650-968-3888
Practice Address - Fax:650-641-8980
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-25
Last Update Date:2010-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA450571223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics