Healthcare Provider Details

I. General information

NPI: 1104413822
Provider Name (Legal Business Name): M. JOE DENTAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/29/2020
Last Update Date: 07/28/2026
Certification Date: 07/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

516 W. REMINGTON DR BLDG 5A
SUNNYVALE CA
94087-2470
US

IV. Provider business mailing address

516 W. REMINGTON DR BLDG 5A
SUNNYVALE CA
94087-2470
US

V. Phone/Fax

Practice location:
  • Phone: 408-736-0888
  • Fax: 408-736-7973
Mailing address:
  • Phone: 408-736-0888
  • Fax: 408-736-7973

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number
License Number State

VIII. Authorized Official

Name: DR. MICHAEL BRADFORD JOE
Title or Position: OWNER/DENTIST
Credential: DDS
Phone: 408-738-0888