Provider Demographics
NPI:1568688372
Name:HAHN, RICHARD CLINTON (DDS)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:CLINTON
Last Name:HAHN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24541 PACIFIC PARK DR
Mailing Address - Street 2:SUITE 210
Mailing Address - City:ALISO VIEJO
Mailing Address - State:CA
Mailing Address - Zip Code:92656-3065
Mailing Address - Country:US
Mailing Address - Phone:949-831-4193
Mailing Address - Fax:949-831-4197
Practice Address - Street 1:24541 PACIFIC PARK DR
Practice Address - Street 2:SUITE 210
Practice Address - City:ALISO VIEJO
Practice Address - State:CA
Practice Address - Zip Code:92656-3065
Practice Address - Country:US
Practice Address - Phone:949-831-4193
Practice Address - Fax:949-831-4197
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA28565122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist