Provider Demographics
NPI:1437180247
Name:SOUTHWEST ENDODONTICS & PERIODONTICS
Entity Type:Organization
Organization Name:SOUTHWEST ENDODONTICS & PERIODONTICS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOONG
Authorized Official - Middle Name:H
Authorized Official - Last Name:HAHN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS MSD
Authorized Official - Phone:440-546-1116
Mailing Address - Street 1:1000 W WALLINGS RD
Mailing Address - Street 2:SUITE B SOUTHWEST ENDO & PERIO INC
Mailing Address - City:BROADVIEW HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44147
Mailing Address - Country:US
Mailing Address - Phone:440-546-1116
Mailing Address - Fax:440-546-0111
Practice Address - Street 1:1000 W WALLINGS RD
Practice Address - Street 2:SUITE B SOUTHWEST ENDO & PERIO INC
Practice Address - City:BROADVIEW HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44147
Practice Address - Country:US
Practice Address - Phone:440-546-1116
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-06
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223E0200XDental ProvidersDentistEndodonticsGroup - Single Specialty