Provider Demographics
NPI:1225157597
Name:TAN, DANNY (DDS)
Entity Type:Individual
Prefix:
First Name:DANNY
Middle Name:
Last Name:TAN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:324 BUSH ST
Mailing Address - Street 2:608 E BORONDA RD STE B
Mailing Address - City:SALINAS
Mailing Address - State:CA
Mailing Address - Zip Code:93907-2026
Mailing Address - Country:US
Mailing Address - Phone:831-449-9776
Mailing Address - Fax:831-449-9451
Practice Address - Street 1:608 E BORONDA RD
Practice Address - Street 2:SUITE B
Practice Address - City:SALINAS
Practice Address - State:CA
Practice Address - Zip Code:93907-2026
Practice Address - Country:US
Practice Address - Phone:831-449-9776
Practice Address - Fax:831-449-9451
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA40989122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist