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General NPI Number Information
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NPI Number | 1598977035
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Entity Type | Individual
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Provider Name | MARY JUNE CONCEPCION D.M.D.
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Gender | Female
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Dates
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Enumeration Date | 05/04/2007
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Last Update Date | 12/03/2021
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Provider Practice Location Address
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Address Line | 1303 JACKLIN RD
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City | MILPITAS
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State | CA
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Zip | 95035-3426
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Country | US
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Telephone | 408-719-1197
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Fax | 408-719-0593
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Provider Business Mailing Address
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Address Line | 5815 PALA MESA DR
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City | SAN JOSE
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State | CA
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Zip | 95123-4474
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Country | US
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Telephone | 408-972-7828
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Fax | 408-719-0593
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 46576
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License Number State | CA
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