Provider Demographics
NPI:1821188277
Name:XIANG NING HAN DDS DENTAL CORPORATION
Entity Type:Organization
Organization Name:XIANG NING HAN DDS DENTAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:XIANG NING
Authorized Official - Middle Name:
Authorized Official - Last Name:HAN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:909-627-5856
Mailing Address - Street 1:4439 E MISSION BLVD
Mailing Address - Street 2:# E
Mailing Address - City:MONTCLAIR
Mailing Address - State:CA
Mailing Address - Zip Code:91763-6067
Mailing Address - Country:US
Mailing Address - Phone:909-627-5856
Mailing Address - Fax:909-627-5269
Practice Address - Street 1:4439 E MISSION BLVD
Practice Address - Street 2:# E
Practice Address - City:MONTCLAIR
Practice Address - State:CA
Practice Address - Zip Code:91763-6067
Practice Address - Country:US
Practice Address - Phone:909-627-5856
Practice Address - Fax:909-627-5269
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-14
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA484591223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA48459CAOtherDELTA DENTAL
CAB4845901OtherHEALTHY FAMILIES
CA48459CAOtherDELTA DENTAL