=====================================================
General NPI Number Information
=====================================================
NPI Number | 1841436227
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | HANH HUYNH QUAN, D.D.S.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/06/2009
-----------------------------------------------------
Last Update Date | 01/06/2009
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 14571 MAGNOLIA ST SUITE 202
-----------------------------------------------------
City | WESTMINSTER
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 92683-5574
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 714-897-9985
-----------------------------------------------------
Fax | 714-897-9989
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 14571 MAGNOLIA ST SUITE 202
-----------------------------------------------------
City | WESTMINSTER
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 92683-5574
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 714-897-9985
-----------------------------------------------------
Fax | 714-897-9989
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | DR. HANH HUYNH QUAN
-----------------------------------------------------
Credential | D.D.S.
-----------------------------------------------------
Telephone | 714-897-9985
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 1223G0001X
-----------------------------------------------------
Taxonomy Name | General Practice Dentistry
-----------------------------------------------------
License Number | B 32981-01
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------