Provider Demographics
NPI:1366643314
Name:BRIAN HUNG HAN DMD INC
Entity Type:Organization
Organization Name:BRIAN HUNG HAN DMD INC
Other - Org Name:GREENHOUSE DENTAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:HUNG
Authorized Official - Last Name:HAN
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:510-347-1350
Mailing Address - Street 1:699 LEWELLING BLVD
Mailing Address - Street 2:SUITE 286
Mailing Address - City:SAN LEANDRO
Mailing Address - State:CA
Mailing Address - Zip Code:94579-1870
Mailing Address - Country:US
Mailing Address - Phone:510-347-1350
Mailing Address - Fax:
Practice Address - Street 1:699 LEWELLING BLVD
Practice Address - Street 2:SUITE 286
Practice Address - City:SAN LEANDRO
Practice Address - State:CA
Practice Address - Zip Code:94579-1870
Practice Address - Country:US
Practice Address - Phone:510-347-1350
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-29
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty