MEDICARE: SUSAN QUAN RDH

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	124Q00000X	Dental Hygienist	15140	CA

General Provider Information

NPI Number	:	1821942806
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SUSAN QUAN RDH

Provider Business Mailing Address
First Line	:	19399 DOUGHERTY AVE
Second Line	:
City	:	MORGAN HILL
State	:	CA
Zip	:	95037-2538
Country	:	US
Telephone Number	:	408-371-7616
Fax Number	:

Provider Business Practice Location Address
First Line	:	2160 S BASCOM AVE
Second Line	:
City	:	CAMPBELL
State	:	CA
Zip	:	95008-3294
Country	:	US
Telephone Number	:	408-371-7616
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/25/2026
Last Update Date	:	02/25/2026

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Directions to “ SUSAN QUAN RDH” Practice Location

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