DENTIST NPI 1588030480

NPI Information

  • NPI: 1588030480
  • Provider Name: DENTIST
  • Classification: Dentist - 1223P0700X
  • Specialization: Prosthodontics
  • Entity Type: Organization
  • Address: 39038 SUTTER DR
    FREMONT, CA
    ZIP 94538
  • Phone: (510) 709-7181

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NPI Details

DENTIST is a prosthodontics dentist in Fremont, CA. The provider is that branch of dentistry pertaining to the restoration and maintenance of oral functions, comfort, appearance and health of the patient by the restoration of natural teeth and/or the replacement of missing teeth and contiguous oral and maxillofacial tissues with artificial substitutes. DENTIST NPI is 1588030480. The provider is registered as an organization entity type and is a multiple single specialty group.

The provider's business location address is:

39038 SUTTER DR
FREMONT, CA
ZIP 94538-141
Phone: (510) 709-7181

The provider's authorized official is Amy Au .
The authorized official title is Dentist and has the following contact phone number (510) 709-7181.

The enumeration date for this NPI number is 8/13/2015 and was last updated on 8/13/2015.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
11223P0700XDentistProsthodontics61629CALIFORNIAYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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