Provider Demographics
NPI:1598362949
Name:THAI, BRIAN BINH (DDS)
Entity Type:Individual
Prefix:
First Name:BRIAN
Middle Name:BINH
Last Name:THAI
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5868 CANNES PL
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95138-2313
Mailing Address - Country:US
Mailing Address - Phone:408-807-6646
Mailing Address - Fax:
Practice Address - Street 1:970 W EL CAMINO REAL STE 1
Practice Address - Street 2:
Practice Address - City:SUNNYVALE
Practice Address - State:CA
Practice Address - Zip Code:94087-1180
Practice Address - Country:US
Practice Address - Phone:650-282-5555
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-07
Last Update Date:2020-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA105455122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist