Provider Demographics
NPI:1538441514
Name:YU, JEANETTE (DDS)
Entity type:Individual
Prefix:DR
First Name:JEANETTE
Middle Name:
Last Name:YU
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 1:1730 FRANKLIN ST
Mailing Address - Street 2:302
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94612-3417
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1730 FRANKLIN ST
Practice Address - Street 2:302
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94612-3417
Practice Address - Country:US
Practice Address - Phone:510-452-1156
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-09-15
Last Update Date:2011-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA60751122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist