Provider Demographics
NPI:1154760536
Name:CLAUDINE ANN YU DDS INC
Entity type:Organization
Organization Name:CLAUDINE ANN YU DDS INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DDS
Authorized Official - Prefix:DR
Authorized Official - First Name:CLAUDINE ANN
Authorized Official - Middle Name:DAVID
Authorized Official - Last Name:YU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:510-648-0099
Mailing Address - Street 1:4455 CENTRAL WAY
Mailing Address - Street 2:SUITE A
Mailing Address - City:FAIRFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:94534-1819
Mailing Address - Country:US
Mailing Address - Phone:707-863-0777
Mailing Address - Fax:707-863-0700
Practice Address - Street 1:4455 CENTRAL WAY
Practice Address - Street 2:SUITE A
Practice Address - City:FAIRFIELD
Practice Address - State:CA
Practice Address - Zip Code:94534-1819
Practice Address - Country:US
Practice Address - Phone:707-863-0777
Practice Address - Fax:707-863-0700
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-06-19
Last Update Date:2013-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA572991223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty