Individual provider Active NPI

Howard J. Quan, D.D.S.

  • General Practice Dentistry
  • Glendale, CA
National Provider Identifier
1275695785
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
26113 Issued in CA
Practice address
540 N Central Ave
Ste 204
Glendale, CA 91203-1916
Phone
(818) 241-5510
Fax
(818) 242-2650
NPI assigned
Dec 14, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 26113 CA Primary

Addresses

Primary practice location

540 N Central Ave
Ste 204
Glendale, CA 91203-1916

Mailing address

540 N Central Ave
Ste 204
Glendale, CA 91203-1916
Phone (818) 241-5510

Other identifiers 1

IdentifierTypeStateIssuer
B26113-01OtherCACA MEDICAL DENTAL PROGRAM

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1166054400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1275695785",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "540 N CENTRAL AVE",
            "address_2": "STE 204",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912031916",
            "telephone_number": "818-241-5510",
            "fax_number": "818-242-2650"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "540 N CENTRAL AVE",
            "address_2": "STE 204",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912031916",
            "telephone_number": "818-241-5510",
            "fax_number": "818-242-2650"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "QUAN",
        "first_name": "HOWARD",
        "middle_name": "J.",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-14",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "26113",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CA MEDICAL DENTAL PROGRAM",
            "identifier": "B26113-01",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendale, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.