Provider Demographics
NPI:1275263261
Name:HEE JO HAN, DMD PLLC
Entity Type:Organization
Organization Name:HEE JO HAN, DMD PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:GENERAL DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:HEE
Authorized Official - Middle Name:JO
Authorized Official - Last Name:HAN
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:703-254-9988
Mailing Address - Street 1:4660 KENMORE AVE STE 800
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22304-1300
Mailing Address - Country:US
Mailing Address - Phone:571-222-5072
Mailing Address - Fax:
Practice Address - Street 1:4660 KENMORE AVE STE 800
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22304-1300
Practice Address - Country:US
Practice Address - Phone:571-222-5072
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-13
Last Update Date:2022-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental