Healthcare Provider Details

I. General information

NPI: 1902974397
Provider Name (Legal Business Name): SUHAIR SALIM HANHAN DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/01/2006
Last Update Date: 03/07/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 MCLELLAN DRIVE SUITE 1073
SOUTH SAN FRANCISCO CA
94080
US

IV. Provider business mailing address

100 MCLELLAN DRIVE SUITE 1073
SOUTH SAN FRANCISCO CA
94080
US

V. Phone/Fax

Practice location:
  • Phone: 650-871-5217
  • Fax: 650-588-6590
Mailing address:
  • Phone: 415-473-5454
  • Fax: 415-473-5460

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223D0001X
TaxonomyPublic Health Dentistry
License Number52989
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: