Provider Demographics
NPI:1780886911
Name:WU, KENNY Y (DDS)
Entity type:Individual
Prefix:
First Name:KENNY
Middle Name:Y
Last Name:WU
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 1:20395 PACIFICA DR STE 101
Mailing Address - Street 2:
Mailing Address - City:CUPERTINO
Mailing Address - State:CA
Mailing Address - Zip Code:95014-3016
Mailing Address - Country:US
Mailing Address - Phone:408-446-0321
Mailing Address - Fax:
Practice Address - Street 1:20395 PACIFICA DR
Practice Address - Street 2:STE 111
Practice Address - City:CUPERTINO
Practice Address - State:CA
Practice Address - Zip Code:95014-3016
Practice Address - Country:US
Practice Address - Phone:626-922-6727
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-01
Last Update Date:2025-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA500201223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice