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General NPI Number Information
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NPI Number | 1528795945
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Entity Type | Individual
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Provider Name | SUZANNE KAN DDS
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Gender | Female
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Dates
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Enumeration Date | 08/05/2022
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Last Update Date | 11/11/2024
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Provider Practice Location Address
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Address Line | 3140 SAWTELLE BLVD APT 206
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City | LOS ANGELES
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State | CA
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Zip | 90066-1441
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Country | US
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Telephone | 808-600-1908
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Fax |
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Provider Business Mailing Address
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Address Line | 3140 SAWTELLE BLVD APT 206
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City | LOS ANGELES
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State | CA
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Zip | 90066-1441
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Country | US
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Telephone | 808-600-1908
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number | DT-3188-0
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License Number State | HI
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Taxonomy #2
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number | 108479
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License Number State | CA
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