Provider Demographics
NPI:1023022811
Name:HAN, INJOO (DDS)
Entity Type:Individual
Prefix:DR
First Name:INJOO
Middle Name:
Last Name:HAN
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 1:4355 GOLDEN CENTER DR STE A
Mailing Address - Street 2:
Mailing Address - City:PLACERVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95667-6260
Mailing Address - Country:US
Mailing Address - Phone:530-622-3430
Mailing Address - Fax:530-622-9733
Practice Address - Street 1:4355 GOLDEN CENTER DR STE A
Practice Address - Street 2:
Practice Address - City:PLACERVILLE
Practice Address - State:CA
Practice Address - Zip Code:95667-6260
Practice Address - Country:US
Practice Address - Phone:530-622-3430
Practice Address - Fax:530-622-9733
Is Sole Proprietor?:No
Enumeration Date:2006-07-28
Last Update Date:2007-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA482831223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice