MEDICARE: ANDREW D HARSANY DDS INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223S0112X	Oral and Maxillofacial Surgery (Dentist)	19432	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	736906	OTHER	CA	UNITED CONCORDIA

General Provider Information

NPI Number	:	1427182179
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ANDREW D HARSANY DDS INC

Provider Business Mailing Address
First Line	:	2945 THE VILLAGES PARKWAY
Second Line	:
City	:	SAN JOSE
State	:	CA
Zip	:	95135
Country	:	US
Telephone Number	:	408-270-9450
Fax Number	:	408-270-9455

Provider Business Practice Location Address
First Line	:	2945 THE VILLAGES PARKWAY
Second Line	:
City	:	SAN JOSE
State	:	CA
Zip	:	95135
Country	:	US
Telephone Number	:	408-270-9450
Fax Number	:	408-270-9455

Authorized Official
Title or Position	:	PRESIDENT ORAL SURGEON
Name	:	ANDREW D HARSANY
Credential	:	DDS
Telephone Number	:	408-270-9450

Provider Enumeration Date	:	03/15/2007
Last Update Date	:	01/13/2012

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