Provider Demographics
NPI:1497317085
Name:HAN, SOL (DR)
Entity Type:Individual
Prefix:
First Name:SOL
Middle Name:
Last Name:HAN
Suffix:
Gender:F
Credentials:DR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:800 PARK AVE PH 2B
Mailing Address - Street 2:
Mailing Address - City:FORT LEE
Mailing Address - State:NJ
Mailing Address - Zip Code:07024-3784
Mailing Address - Country:US
Mailing Address - Phone:213-454-6752
Mailing Address - Fax:
Practice Address - Street 1:155 N DEAN ST STE 4C
Practice Address - Street 2:
Practice Address - City:ENGLEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:07631-2524
Practice Address - Country:US
Practice Address - Phone:201-308-8114
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-07-03
Last Update Date:2023-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22DI027754001223P0221X
390200000X
NJ22DI027754021223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program