Provider Demographics
NPI:1982816146
Name:SCOTT A. HOFFMAN, DDS INC
Entity Type:Organization
Organization Name:SCOTT A. HOFFMAN, DDS INC
Other - Org Name:SCOTT A. HOFFMAN, DDS INC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:A
Authorized Official - Last Name:HOFFMAN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:650-325-1332
Mailing Address - Street 1:825 OAK GROVE AVE.
Mailing Address - Street 2:SUITE # 301
Mailing Address - City:MENLO PARK
Mailing Address - State:CA
Mailing Address - Zip Code:94025
Mailing Address - Country:US
Mailing Address - Phone:650-325-1332
Mailing Address - Fax:650-325-4376
Practice Address - Street 1:825 OAK GROVE AVE.
Practice Address - Street 2:SUITE # 301
Practice Address - City:MENLO PARK
Practice Address - State:CA
Practice Address - Zip Code:94025
Practice Address - Country:US
Practice Address - Phone:650-325-1332
Practice Address - Fax:650-325-4376
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-03
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA28717122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1952498206OtherSCOTT HOFFMAN, DDS