Healthcare Provider Details

I. General information

NPI: 1548046915
Provider Name (Legal Business Name): TUAN DANNY DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/01/2023
Last Update Date: 06/23/2026
Certification Date: 06/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1500 CAPITOLA RD
SANTA CRUZ CA
95062-2912
US

IV. Provider business mailing address

1500 CAPITOLA RD
SANTA CRUZ CA
95062-2912
US

V. Phone/Fax

Practice location:
  • Phone: 831-464-5409
  • Fax: 831-464-5415
Mailing address:
  • Phone: 831-464-5409
  • Fax: 831-464-5415

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0221X
TaxonomyPediatric Dentistry
License NumberDDS112738
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: