Provider Demographics
NPI:1467584334
Name:HA, HANH HONG (DDS)
Entity Type:Individual
Prefix:DR
First Name:HANH
Middle Name:HONG
Last Name:HA
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 1:1419 BIRD AVE
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95125-1815
Mailing Address - Country:US
Mailing Address - Phone:408-297-8505
Mailing Address - Fax:
Practice Address - Street 1:1409 BIRD AVE STE F
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95125-1867
Practice Address - Country:US
Practice Address - Phone:408-297-8505
Practice Address - Fax:408-297-2373
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-09
Last Update Date:2016-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CACA429161223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice