Provider Demographics
NPI:1548828486
Name:GIANG, BRYANT VAN (DDS)
Entity type:Individual
Prefix:
First Name:BRYANT
Middle Name:VAN
Last Name:GIANG
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1005 S BURRUS ST
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67207-3609
Mailing Address - Country:US
Mailing Address - Phone:316-207-4237
Mailing Address - Fax:
Practice Address - Street 1:2814 OHIO ST
Practice Address - Street 2:
Practice Address - City:AUGUSTA
Practice Address - State:KS
Practice Address - Zip Code:67010-2361
Practice Address - Country:US
Practice Address - Phone:316-755-5451
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-06-05
Last Update Date:2022-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS61628122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist