Healthcare Provider Details

I. General information

NPI: 1407303175
Provider Name (Legal Business Name): DANIEL HOFFMAN DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/09/2016
Last Update Date: 09/09/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1785 SAN CARLOS AVE STE 3
SAN CARLOS CA
94070-2026
US

IV. Provider business mailing address

22230 VARIAN WAY
CUPERTINO CA
95014-1065
US

V. Phone/Fax

Practice location:
  • Phone: 650-591-0995
  • Fax:
Mailing address:
  • Phone: 408-529-9946
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number100577
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number100577
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: