MEDICARE: VAN-KHOA QUAN DDS

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	1223P0221X	Pediatric Dentistry	LL-414-16	NV
2	1223P0221X	Pediatric Dentistry	101034	CA

General Provider Information

NPI Number	:	1518354653
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	VAN-KHOA QUAN DDS

Provider Business Mailing Address
First Line	:	6855 WARNER AVE
Second Line	:
City	:	HUNTINGTON BEACH
State	:	CA
Zip	:	92647-5303
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	6855 WARNER AVE
Second Line	:
City	:	HUNTINGTON BEACH
State	:	CA
Zip	:	92647-5303
Country	:	US
Telephone Number	:	714-465-4178
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/15/2015
Last Update Date	:	05/05/2025

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Directions to “ VAN-KHOA QUAN DDS” Practice Location

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