Provider Demographics
NPI:1043418346
Name:HAN, YANGSOOK (DDS)
Entity Type:Individual
Prefix:DR
First Name:YANGSOOK
Middle Name:
Last Name:HAN
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 1:930 E TREMONT AVE
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10460-4363
Mailing Address - Country:US
Mailing Address - Phone:718-764-1633
Mailing Address - Fax:646-224-1320
Practice Address - Street 1:930 E TREMONT AVE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10460-4363
Practice Address - Country:US
Practice Address - Phone:718-764-1633
Practice Address - Fax:646-224-1320
Is Sole Proprietor?:No
Enumeration Date:2007-07-07
Last Update Date:2013-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0531811223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY053181OtherLICENSE NUMBER