Healthcare Provider Details

I. General information

NPI: 1598691412
Provider Name (Legal Business Name): ADDISON YU, DDS, DENTAL CORP.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/18/2026
Last Update Date: 07/18/2026
Certification Date: 07/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

301 LENNON LN STE 101
WALNUT CREEK CA
94598-2467
US

IV. Provider business mailing address

301 LENNON LN STE 101
WALNUT CREEK CA
94598-2467
US

V. Phone/Fax

Practice location:
  • Phone: 925-934-8668
  • Fax:
Mailing address:
  • Phone:
  • Fax:

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. ADDISON YU
Title or Position: DENTIST
Credential: DDS
Phone: 415-309-5087