Provider Demographics
NPI:1518487826
Name:HAHN, ERIKA RAE (DDS)
Entity Type:Individual
Prefix:DR
First Name:ERIKA
Middle Name:RAE
Last Name:HAHN
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 1:3115 WESTPOINT CIRCLE
Mailing Address - Street 2:
Mailing Address - City:RIVERSIDE
Mailing Address - State:IA
Mailing Address - Zip Code:52327
Mailing Address - Country:US
Mailing Address - Phone:641-430-6642
Mailing Address - Fax:
Practice Address - Street 1:2201 COLUMBUS ST
Practice Address - Street 2:
Practice Address - City:COLUMBUS CITY
Practice Address - State:IA
Practice Address - Zip Code:52737-9000
Practice Address - Country:US
Practice Address - Phone:319-728-8100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-06-27
Last Update Date:2017-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA094021223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice