Provider Demographics
NPI:1326354994
Name:HANS, CANDY (DDS)
Entity Type:Individual
Prefix:DR
First Name:CANDY
Middle Name:
Last Name:HANS
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2000 WALNUT AVE APT 103
Mailing Address - Street 2:
Mailing Address - City:FREMONT
Mailing Address - State:CA
Mailing Address - Zip Code:94538-5315
Mailing Address - Country:US
Mailing Address - Phone:510-506-0013
Mailing Address - Fax:
Practice Address - Street 1:38062 MARTHA AVE
Practice Address - Street 2:
Practice Address - City:FREMONT
Practice Address - State:CA
Practice Address - Zip Code:94536-3809
Practice Address - Country:US
Practice Address - Phone:510-792-9292
Practice Address - Fax:510-792-9296
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-20
Last Update Date:2010-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA597001223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice