Provider Demographics
NPI:1003425208
Name:PAN, HSIN-CHUAN (DDS, MS)
Entity Type:Individual
Prefix:DR
First Name:HSIN-CHUAN
Middle Name:
Last Name:PAN
Suffix:
Gender:M
Credentials:DDS, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1321 5TH LN
Mailing Address - Street 2:
Mailing Address - City:KIRKLAND
Mailing Address - State:WA
Mailing Address - Zip Code:98033-5667
Mailing Address - Country:US
Mailing Address - Phone:213-221-5482
Mailing Address - Fax:
Practice Address - Street 1:12305 120TH AVE NE STE G
Practice Address - Street 2:
Practice Address - City:KIRKLAND
Practice Address - State:WA
Practice Address - Zip Code:98034-6921
Practice Address - Country:US
Practice Address - Phone:425-588-3899
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-07-24
Last Update Date:2024-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI29016005311223X0400X
WADE611317461223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty