Jeremy Kaoru Ueno, D.M.D.

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

License

58308 Issued in CA

Practice address

2160 S Bascom Ave
Suite #1
Campbell, CA 95008-3294

Phone

(408) 371-7616

Fax

(408) 371-7651

NPI assigned

Jun 6, 2009

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Apr 2, 2026 through Apr 2, 2028

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1244246400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1484265600000",
    "number": "1659507432",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2160 S BASCOM AVE",
            "address_2": "SUITE #1",
            "city": "CAMPBELL",
            "state": "CA",
            "postal_code": "950083294",
            "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",
            "address_2": "SUITE #1",
            "city": "CAMPBELL",
            "state": "CA",
            "postal_code": "950083294",
            "telephone_number": "408-371-7616",
            "fax_number": "408-371-7651"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "UENO",
        "first_name": "JEREMY",
        "middle_name": "KAORU",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-06-06",
        "last_updated": "2017-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "CA",
            "license": "58308",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kaitlyn Turnbull, LMFT
• Katie Marie Turner, M.A., BCBA
• Alison R Turney, PT
• Briana Lauren Tyler-Funes
• Tyrone & Dayna Isquirdo Chiropractic Corporation
• Stephani Dung Ueno, DMD
• Gale Blake Uhl, PH.D.
• Raymond Noboru Umeda, O.D.
• University Healthcare Alliance
• Sarah B Uribe

• Periodontics in Campbell, CA
• Providers in Campbell, CA by specialty
• Periodontics in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.