Individual
JING YE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DMD, MSD
Contact information
Practice address
286 JUANA AVE, SAN LEANDRO, CA 94577-4839
(510) 895-1470
Mailing address
1214 MIRABEAU LN, SAN JOSE, CA 95132-2885
(484) 886-6408
Taxonomy
Speciality
Code
Description
License number
State
1223E0200X
Endodontics
Primary
104148
CA
1223G0001X
General Practice Dentistry
104148
CA
390200000X
Student in an Organized Health Care Education/Training Program
0401417497
VA
390200000X
Student in an Organized Health Care Education/Training Program
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Other
Enumeration date
05/05/2018
Last updated
07/10/2023
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