Provider Demographics
NPI:1467999250
Name:JOHN C HAN DDS INC
Entity Type:Organization
Organization Name:JOHN C HAN DDS INC
Other - Org Name:PREFERRED DENTAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DENTIST/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:C
Authorized Official - Last Name:HAN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:909-885-4848
Mailing Address - Street 1:1895 ORANGE TREE LN
Mailing Address - Street 2:103
Mailing Address - City:REDLANDS
Mailing Address - State:CA
Mailing Address - Zip Code:92374-0111
Mailing Address - Country:US
Mailing Address - Phone:909-885-4848
Mailing Address - Fax:909-435-0511
Practice Address - Street 1:1895 ORANGE TREE LN
Practice Address - Street 2:103
Practice Address - City:REDLANDS
Practice Address - State:CA
Practice Address - Zip Code:92374-0111
Practice Address - Country:US
Practice Address - Phone:909-885-4848
Practice Address - Fax:909-435-0511
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-01-31
Last Update Date:2017-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA45263122300000X, 332BC3200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty
No332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized EquipmentGroup - Single Specialty