Provider Demographics
NPI:1699771915
Name:HOO, BALDWIN JIN (DDS)
Entity type:Individual
Prefix:DR
First Name:BALDWIN
Middle Name:JIN
Last Name:HOO
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1150 EL CAMINO REAL STE 128
Mailing Address - Street 2:
Mailing Address - City:SAN BRUNO
Mailing Address - State:CA
Mailing Address - Zip Code:94066-2422
Mailing Address - Country:US
Mailing Address - Phone:650-873-8888
Mailing Address - Fax:650-873-8787
Practice Address - Street 1:1150 EL CAMINO REAL STE 128
Practice Address - Street 2:
Practice Address - City:SAN BRUNO
Practice Address - State:CA
Practice Address - Zip Code:94066-2422
Practice Address - Country:US
Practice Address - Phone:650-873-8888
Practice Address - Fax:650-873-8787
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA34714122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist