1427124528 NPI number — MISS YINGHUI PAN DDS

Table of content: MISS YINGHUI PAN DDS (NPI 1427124528)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1427124528 NPI number — MISS YINGHUI PAN DDS

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
PAN
Provider First Name:
YINGHUI
Provider Middle Name:
Provider Name Prefix Text:
MISS
Provider Name Suffix Text:
Provider Credential Text:
DDS
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
PAN
Provider Other First Name:
DAWN
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
DDS
Provider Other Last Name Type Code:
2

NPI Number Information

NPI Number:
1427124528
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
8060 SANTA TERESA BLVD
Provider Second Line Business Mailing Address:
#120
Provider Business Mailing Address City Name:
GILROY
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
95020-3867
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
408-846-8899
Provider Business Mailing Address Fax Number:
408-847-0008

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
8060 SANTA TERESA BLVD
Provider Second Line Business Practice Location Address:
#120
Provider Business Practice Location Address City Name:
GILROY
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
95020-3867
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
408-846-8899
Provider Business Practice Location Address Fax Number:
408-847-0008
Provider Enumeration Date:
11/28/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 1223G0001X , with the licence number:  45306 , 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)