Provider Demographics
NPI:1942214754
Name:HANA DENTAL CARE P.C.
Entity Type:Organization
Organization Name:HANA DENTAL CARE P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:HAN
Authorized Official - Middle Name:JONG
Authorized Official - Last Name:KANG
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:718-392-3634
Mailing Address - Street 1:3931 47TH AVE
Mailing Address - Street 2:
Mailing Address - City:SUNNYSIDE
Mailing Address - State:NY
Mailing Address - Zip Code:11104-3576
Mailing Address - Country:US
Mailing Address - Phone:718-392-3634
Mailing Address - Fax:718-392-2703
Practice Address - Street 1:3931 47TH AVE
Practice Address - Street 2:
Practice Address - City:SUNNYSIDE
Practice Address - State:NY
Practice Address - Zip Code:11104-3576
Practice Address - Country:US
Practice Address - Phone:718-392-3634
Practice Address - Fax:718-392-2703
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-28
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0487681223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02064120Medicaid