Provider Demographics
NPI:1427182179
Name:ANDREW D HARSANY DDS INC
Entity Type:Organization
Organization Name:ANDREW D HARSANY DDS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT ORAL SURGEON
Authorized Official - Prefix:
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:D
Authorized Official - Last Name:HARSANY
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:408-270-9450
Mailing Address - Street 1:2945 THE VILLAGES PARKWAY
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95135
Mailing Address - Country:US
Mailing Address - Phone:408-270-9450
Mailing Address - Fax:408-270-9455
Practice Address - Street 1:2945 THE VILLAGES PARKWAY
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95135
Practice Address - Country:US
Practice Address - Phone:408-270-9450
Practice Address - Fax:408-270-9455
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-15
Last Update Date:2012-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA194321223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA736906OtherUNITED CONCORDIA
CA736906OtherUNITED CONCORDIA