Provider Demographics
NPI:1790368306
Name:ALEXANDER HAHN DENTAL SERVICES LLC
Entity Type:Organization
Organization Name:ALEXANDER HAHN DENTAL SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ALEXANDER
Authorized Official - Middle Name:STEVEN
Authorized Official - Last Name:HAHN
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:609-468-2339
Mailing Address - Street 1:200 GREENE ST APT 5806
Mailing Address - Street 2:
Mailing Address - City:JERSEY CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:07311-1466
Mailing Address - Country:US
Mailing Address - Phone:609-468-2339
Mailing Address - Fax:
Practice Address - Street 1:75 MONTGOMERY ST FL 503
Practice Address - Street 2:
Practice Address - City:JERSEY CITY
Practice Address - State:NJ
Practice Address - Zip Code:07302-3726
Practice Address - Country:US
Practice Address - Phone:201-200-0500
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-05-02
Last Update Date:2021-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ1316965205Medicaid
NJ1023541711Medicaid