Healthcare Provider Details

I. General information

NPI: 1114172988
Provider Name (Legal Business Name): SAI FAN YU DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/20/2008
Last Update Date: 04/24/2026
Certification Date: 04/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1801 TULLY RD STE D1
MODESTO CA
95350-2937
US

IV. Provider business mailing address

334 SHAW AVE STE 125
CLOVIS CA
93612-3865
US

V. Phone/Fax

Practice location:
  • Phone: 209-526-9430
  • Fax:
Mailing address:
  • Phone: 559-297-8000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number57751
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: