Provider Demographics
NPI:1902974397
Name:HANHAN, SUHAIR SALIM (DDS)
Entity Type:Individual
Prefix:MRS
First Name:SUHAIR
Middle Name:SALIM
Last Name:HANHAN
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 MCLELLAN DRIVE
Mailing Address - Street 2:SUITE 1073
Mailing Address - City:SOUTH SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94080
Mailing Address - Country:US
Mailing Address - Phone:415-473-5454
Mailing Address - Fax:415-473-5460
Practice Address - Street 1:100 MCLELLAN DRIVE
Practice Address - Street 2:SUITE 1073
Practice Address - City:SOUTH SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94080
Practice Address - Country:US
Practice Address - Phone:650-871-5217
Practice Address - Fax:650-588-6590
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-01
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA529891223D0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223D0001XDental ProvidersDentistDental Public Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CABH898177OtherDEA