MEDICARE: MRS. SUHAIR SALIM HANHAN DDS

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	1223D0001X	Public Health Dentistry	52989	CA

General Provider Information

NPI Number	:	1902974397
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. SUHAIR SALIM HANHAN DDS

Provider Business Mailing Address
First Line	:	100 MCLELLAN DRIVE
Second Line	:	SUITE 1073
City	:	SOUTH SAN FRANCISCO
State	:	CA
Zip	:	94080
Country	:	US
Telephone Number	:	415-473-5454
Fax Number	:	415-473-5460

Provider Business Practice Location Address
First Line	:	100 MCLELLAN DRIVE
Second Line	:	SUITE 1073
City	:	SOUTH SAN FRANCISCO
State	:	CA
Zip	:	94080
Country	:	US
Telephone Number	:	650-871-5217
Fax Number	:	650-588-6590

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

Provider Enumeration Date	:	12/01/2006
Last Update Date	:	03/07/2023

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