Provider Demographics
NPI:1225161136
Name:JEFFREY A. HANIN DDS,INC.
Entity Type:Organization
Organization Name:JEFFREY A. HANIN DDS,INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:ALLEN
Authorized Official - Last Name:HANIN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:614-237-2529
Mailing Address - Street 1:3370 E BROAD ST
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43213-1008
Mailing Address - Country:US
Mailing Address - Phone:614-237-2529
Mailing Address - Fax:614-237-4358
Practice Address - Street 1:3370 E BROAD ST
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43213-1008
Practice Address - Country:US
Practice Address - Phone:614-237-2529
Practice Address - Fax:614-237-4358
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-13
Last Update Date:2015-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty