Provider Demographics
NPI:1518286145
Name:HA, DAN-LINH (DDS)
Entity Type:Individual
Prefix:DR
First Name:DAN-LINH
Middle Name:
Last Name:HA
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1050 WISHARD BLVD
Mailing Address - Street 2:RG 4201
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46202-2872
Mailing Address - Country:US
Mailing Address - Phone:317-278-3662
Mailing Address - Fax:317-278-2243
Practice Address - Street 1:1050 WISHARD BLVD
Practice Address - Street 2:RG 4201
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46202-2872
Practice Address - Country:US
Practice Address - Phone:317-278-3662
Practice Address - Fax:317-278-2243
Is Sole Proprietor?:No
Enumeration Date:2010-05-21
Last Update Date:2010-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN12011435A122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist