MEDICARE: DR. MASLY HARSONO DDS, MS, DMD

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	1223G0001X	General Practice	DN1855466	MA
2	1223G0001X	General Practice	DN1855466	MA

General Provider Information

NPI Number	:	1669893731
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MASLY HARSONO DDS, MS, DMD

Provider Business Mailing Address
First Line	:	550 MORELAND WAY
Second Line	:	4512
City	:	SANTA CLARA
State	:	CA
Zip	:	950544123
Country	:	US
Telephone Number	:	650-667-1369
Fax Number	:

Provider Business Practice Location Address
First Line	:	826 E FREMONT AVE
Second Line	:	SUITE D
City	:	SUNNYVALE
State	:	CA
Zip	:	940873651
Country	:	US
Telephone Number	:	650-667-1369
Fax Number	:

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

Provider Enumeration Date	:	12/17/2013
Last Update Date	:	10/06/2016

Similar Medicare Providers

1154324572 — SILICON VALLEY EYE PHYSICIANS
Practice Location Address:

1010 W FREMONT AVE , STE 200
SUNNYVALE, CA
94087-3019

Practice Phone: 408-739-6200
Practice Fax: 408-739-2439

1487659769 — PATHWAYS HOME HEALTH AND HOSPICE
Practice Location Address:

585 N MARY AVE
SUNNYVALE, CA
94085-2905

Practice Phone: 408-730-1500
Practice Fax: 408-730-8726

1841292455 — DR. SALIMA LYDIA BRILLMAN MD
Practice Location Address:

675 ALMANOR AVE
SUNNYVALE, CA
94085-2934

Practice Phone: 408-734-2800
Practice Fax: 408-734-9208

1306838602 — MISS CHERYL ANN KELLEY NP
Practice Location Address:

5311 BIG SPRING HWY
SNYDER, TX
79549-6347

Practice Phone: 325-776-2500
Practice Fax: 325-776-2355

1669467445 — ROBERT EDWIN BROCKIE MD
Practice Location Address:

490 US HIGHWAY 80 E STE 100
SUNNYVALE, TX
75182-9212

Practice Phone: 972-279-3500
Practice Fax: 972-279-3505

1528053139 — COUNTY OF SANTA CLARA
Practice Location Address:

660 S FAIR OAKS AVE , VHC SUNNYVALE
SUNNYVALE, CA
94086-7913

Practice Phone: 408-885-5000
Practice Fax:

1326001843 — AGHA MASROOR ABBAS MD
Practice Location Address:

231 S COLLINS RD
SUNNYVALE, TX
75182-4624

Practice Phone: 972-892-3000
Practice Fax:

Directions to “ DR. MASLY HARSONO DDS, MS, DMD” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2025 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.