1063624708 NPI number — SILVIE THU-HIEN QUACH, D.D.S., A PROFESSIONAL CORPORATION

Table of content: (NPI 1063624708)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1063624708 NPI number — SILVIE THU-HIEN QUACH, D.D.S., A PROFESSIONAL CORPORATION

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
SILVIE THU-HIEN QUACH, D.D.S., A PROFESSIONAL CORPORATION
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1063624708
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/23/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
88 WEST TULLY RD.
Provider Second Line Business Mailing Address:
103
Provider Business Mailing Address City Name:
SAN JOSE
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
95111
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
510-965-9000
Provider Business Mailing Address Fax Number:
510-965-9009

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
404 SAN PABLO TOWNE CTR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SAN PABLO
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
94806-3933
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
510-965-9000
Provider Business Practice Location Address Fax Number:
510-965-9009
Provider Enumeration Date:
05/04/2007

Additional Information

Authorized Official

Authorized Official Last Name:
QUACH
Authorized Official First Name:
SILVIE
Authorized Official Middle Name:
THU-HIEN
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
510-965-9000

Provider Taxonomy Codes

  • Taxonomy code: 122300000X , with the licence number:  43065 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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