Provider Demographics
NPI:1932327129
Name:QUAN, KHUE HANH (DDS)
Entity Type:Individual
Prefix:
First Name:KHUE
Middle Name:HANH
Last Name:QUAN
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:KHUE
Other - Middle Name:
Other - Last Name:LUU
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DDS
Mailing Address - Street 1:14571 MAGNOLIA ST
Mailing Address - Street 2:SUITE 202
Mailing Address - City:WESTMINSTER
Mailing Address - State:CA
Mailing Address - Zip Code:92683
Mailing Address - Country:US
Mailing Address - Phone:714-897-9985
Mailing Address - Fax:714-897-9989
Practice Address - Street 1:14571 MAGNOLIA STREET
Practice Address - Street 2:SUITE 202
Practice Address - City:WESTMINSTER
Practice Address - State:CA
Practice Address - Zip Code:92683
Practice Address - Country:US
Practice Address - Phone:714-897-9985
Practice Address - Fax:714-897-9989
Is Sole Proprietor?:No
Enumeration Date:2007-04-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA41466122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
D41466Medicare UPIN