Provider Demographics
NPI:1700252426
Name:YAU, JENNIFER H (DDS, MSD)
Entity type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:H
Last Name:YAU
Suffix:
Gender:F
Credentials:DDS, MSD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14455 S BASCOM AVE
Mailing Address - Street 2:
Mailing Address - City:LOS GATOS
Mailing Address - State:CA
Mailing Address - Zip Code:95032-2002
Mailing Address - Country:US
Mailing Address - Phone:408-377-9797
Mailing Address - Fax:
Practice Address - Street 1:14455 S BASCOM AVE
Practice Address - Street 2:
Practice Address - City:LOS GATOS
Practice Address - State:CA
Practice Address - Zip Code:95032
Practice Address - Country:US
Practice Address - Phone:408-377-9797
Practice Address - Fax:408-377-9143
Is Sole Proprietor?:Yes
Enumeration Date:2015-08-17
Last Update Date:2018-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA645031223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics