Provider Demographics
NPI:1861997819
Name:KUO, YU CHENG GEORGE
Entity type:Individual
Prefix:
First Name:YU CHENG
Middle Name:GEORGE
Last Name:KUO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16411 NE 20TH ST
Mailing Address - Street 2:
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98008-2603
Mailing Address - Country:US
Mailing Address - Phone:425-503-9208
Mailing Address - Fax:
Practice Address - Street 1:990 W FREMONT AVE STE S
Practice Address - Street 2:
Practice Address - City:SUNNYVALE
Practice Address - State:CA
Practice Address - Zip Code:94087-3065
Practice Address - Country:US
Practice Address - Phone:408-736-4101
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-03-29
Last Update Date:2019-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA103863122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist