Provider Demographics
NPI:1881822278
Name:DAVID S. HAN, DDS, INC.
Entity Type:Organization
Organization Name:DAVID S. HAN, DDS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:S
Authorized Official - Last Name:HAN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:909-597-1770
Mailing Address - Street 1:4200 CHINO HILLS PKWY
Mailing Address - Street 2:STE-355
Mailing Address - City:CHINO HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91709-3776
Mailing Address - Country:US
Mailing Address - Phone:909-597-1770
Mailing Address - Fax:909-393-5710
Practice Address - Street 1:4200 CHINO HILLS PKWY
Practice Address - Street 2:STE-355
Practice Address - City:CHINO HILLS
Practice Address - State:CA
Practice Address - Zip Code:91709-3776
Practice Address - Country:US
Practice Address - Phone:909-597-1770
Practice Address - Fax:909-393-5710
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-06-24
Last Update Date:2009-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA392701223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty