Healthcare Provider Details

I. General information

NPI: 1457428815
Provider Name (Legal Business Name): BARBARA GENE WU DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/29/2006
Last Update Date: 03/07/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

125 N JACKSON AVE STE 203
SAN JOSE CA
95116-1903
US

IV. Provider business mailing address

125 N JACKSON AVE STE 203
SAN JOSE CA
95116-1903
US

V. Phone/Fax

Practice location:
  • Phone: 408-259-3383
  • Fax: 408-259-3384
Mailing address:
  • Phone: 408-259-3383
  • Fax: 408-259-3384

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223D0001X
TaxonomyPublic Health Dentistry
License Number54039
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: