Provider Demographics
NPI:1134268295
Name:HANE, WAYNE SETSUO (DDS)
Entity type:Individual
Prefix:DR
First Name:WAYNE
Middle Name:SETSUO
Last Name:HANE
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 1:2790 NEWHALL ST
Mailing Address - Street 2:
Mailing Address - City:SANTA CLARA
Mailing Address - State:CA
Mailing Address - Zip Code:95050-5600
Mailing Address - Country:US
Mailing Address - Phone:408-247-9050
Mailing Address - Fax:408-247-6950
Practice Address - Street 1:2790 NEWHALL ST
Practice Address - Street 2:
Practice Address - City:SANTA CLARA
Practice Address - State:CA
Practice Address - Zip Code:95050-5600
Practice Address - Country:US
Practice Address - Phone:408-247-9050
Practice Address - Fax:408-247-6950
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA375611223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics