Healthcare Provider Details

I. General information

NPI: 1174029326
Provider Name (Legal Business Name): BRIAN KWOK HEI HUI DDS, MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/04/2018
Last Update Date: 01/27/2022
Certification Date: 01/27/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

901 CAMPUS DR STE 303
DALY CITY CA
94015-4930
US

IV. Provider business mailing address

901 CAMPUS DR STE 303
DALY CITY CA
94015-4930
US

V. Phone/Fax

Practice location:
  • Phone: 510-386-7762
  • Fax:
Mailing address:
  • Phone: 650-992-7874
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License Number100218
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: