Provider Demographics
NPI:1841436227
Name:HANH HUYNH QUAN, D.D.S.
Entity type:Organization
Organization Name:HANH HUYNH QUAN, D.D.S.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:HANH
Authorized Official - Middle Name:HUYNH
Authorized Official - Last Name:QUAN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:714-897-9985
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:92683-5574
Mailing Address - Country:US
Mailing Address - Phone:714-897-9985
Mailing Address - Fax:714-897-9989
Practice Address - Street 1:14571 MAGNOLIA ST
Practice Address - Street 2:SUITE 202
Practice Address - City:WESTMINSTER
Practice Address - State:CA
Practice Address - Zip Code:92683-5574
Practice Address - Country:US
Practice Address - Phone:714-897-9985
Practice Address - Fax:714-897-9989
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-06
Last Update Date:2009-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAB 32981-011223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAB 32981-01OtherDENTAL LICENSE
CA503521Medicare PIN