Organization Active NPI

Jeremy K Ueno DMD a Professional Corporation

  • Oral and Maxillofacial Surgery (Dentist)
  • Campbell, CA
National Provider Identifier
1629682901
Registry record updated Sep 4, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
Legal business name
JEREMY K UENO DMD A PROFESSIONAL CORPORATION
Practice address
2160 S Bascom Ave Ste 1
Campbell, CA 95008-3297
Phone
(408) 371-7616
Fax
(408) 371-7615
NPI assigned
Sep 3, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 4, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Jeremy K Ueno, DDS
Title
Owner/Ceo
Phone
(408) 402-2159

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193200000X MULTI-SPECIALTY GROUP 122300000X
Oral and Maxillofacial Surgery (Dentist)Group: 193200000X MULTI-SPECIALTY GROUP 1223S0112X Primary

Addresses

Primary practice location

2160 S Bascom Ave Ste 1
Campbell, CA 95008-3297

Mailing address

2160 S Bascom Ave Ste 1
Campbell, CA 95008-3297
Phone (408) 371-7616

National Provider Directory

National Provider Directory

Locations

2160 S Bascom Ave
Ste 1
Campbell, CA 95008
Phone (408) 371-7616

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1599091200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1599177600000",
    "number": "1629682901",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2160 S BASCOM AVE STE 1",
            "city": "CAMPBELL",
            "state": "CA",
            "postal_code": "950083297",
            "telephone_number": "408-371-7616",
            "fax_number": "408-371-7651"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2160 S BASCOM AVE STE 1",
            "city": "CAMPBELL",
            "state": "CA",
            "postal_code": "950083297",
            "telephone_number": "408-371-7616",
            "fax_number": "408-371-7615"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JEREMY K UENO DMD A PROFESSIONAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-09-03",
        "last_updated": "2020-09-04",
        "certification_date": "2020-09-04",
        "status": "A",
        "authorized_official_last_name": "UENO",
        "authorized_official_first_name": "JEREMY",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "OWNER/CEO",
        "authorized_official_telephone_number": "408-402-2159",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Campbell, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.