Healthcare Provider Details

I. General information

NPI: 1821974429
Provider Name (Legal Business Name): JASMINE KUO DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/12/2025
Last Update Date: 08/12/2025
Certification Date: 08/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6020 HELLYER AVE STE 100
SAN JOSE CA
95138-1016
US

IV. Provider business mailing address

1114 DANBURY DR
SAN JOSE CA
95129-2919
US

V. Phone/Fax

Practice location:
  • Phone: 408-226-2542
  • Fax:
Mailing address:
  • Phone: 408-819-4225
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223D0001X
TaxonomyPublic Health Dentistry
License Number111835
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: