Healthcare Provider Details

I. General information

NPI: 1912461930
Provider Name (Legal Business Name): JEAN MARIE STAR DDS, MPH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JEAN MARIE CALVO DDS

II. Dates (important events)

Enumeration Date: 01/23/2019
Last Update Date: 12/04/2025
Certification Date: 12/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

707 PARNASSUS AVE
SAN FRANCISCO CA
94143-2210
US

IV. Provider business mailing address

707 PARNASSUS AVE
SAN FRANCISCO CA
94143-2210
US

V. Phone/Fax

Practice location:
  • Phone: 415-476-3276
  • Fax:
Mailing address:
  • Phone: 415-476-3276
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0221X
TaxonomyPediatric Dentistry
License Number104643
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: