Provider Demographics
NPI:1558573519
Name:SCOTT AN, DDS,INC.
Entity Type:Organization
Organization Name:SCOTT AN, DDS,INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:
Authorized Official - Last Name:AN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:323-277-9191
Mailing Address - Street 1:2625 E FLORENCE AVE
Mailing Address - Street 2:SUITE # C
Mailing Address - City:HUNTINGTON PARK
Mailing Address - State:CA
Mailing Address - Zip Code:90255-4756
Mailing Address - Country:US
Mailing Address - Phone:323-277-9191
Mailing Address - Fax:323-277-3898
Practice Address - Street 1:2625 E FLORENCE AVE
Practice Address - Street 2:SUITE # C
Practice Address - City:HUNTINGTON PARK
Practice Address - State:CA
Practice Address - Zip Code:90255-4756
Practice Address - Country:US
Practice Address - Phone:323-277-9191
Practice Address - Fax:323-277-3898
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-04
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA48700122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty