Provider Demographics
NPI:1598716334
Name:HAN, DENNIS (MD)
Entity Type:Individual
Prefix:DR
First Name:DENNIS
Middle Name:
Last Name:HAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:925 N 87TH ST
Mailing Address - Street 2:THE EYE INSTITUTE
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53226-4812
Mailing Address - Country:US
Mailing Address - Phone:414-456-2020
Mailing Address - Fax:414-456-6300
Practice Address - Street 1:925 N 87TH ST
Practice Address - Street 2:THE EYE INSTITUTE
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53226-4812
Practice Address - Country:US
Practice Address - Phone:414-456-2020
Practice Address - Fax:414-456-6300
Is Sole Proprietor?:No
Enumeration Date:2006-05-15
Last Update Date:2019-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI27650207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI1598716334Medicaid
002000119NOtherHUMANA
WI0289 68-086Medicare PIN
B53365Medicare UPIN
WI0133 73-601Medicare PIN