Provider Demographics
NPI:1578052288
Name:JOHN HAN
Entity Type:Organization
Organization Name:JOHN HAN
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:HAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:703-757-6453
Mailing Address - Street 1:11515 SUNRISE VALLEY DR
Mailing Address - Street 2:
Mailing Address - City:RESTON
Mailing Address - State:VA
Mailing Address - Zip Code:20191-1505
Mailing Address - Country:US
Mailing Address - Phone:703-757-6453
Mailing Address - Fax:800-349-5255
Practice Address - Street 1:11515 SUNRISE VALLEY DR
Practice Address - Street 2:
Practice Address - City:RESTON
Practice Address - State:VA
Practice Address - Zip Code:20191-1505
Practice Address - Country:US
Practice Address - Phone:703-757-6453
Practice Address - Fax:800-349-5255
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-05-08
Last Update Date:2018-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty