Provider Demographics
NPI:1013075795
Name:HAHN, KAI H (DMD)
Entity Type:Individual
Prefix:
First Name:KAI
Middle Name:H
Last Name:HAHN
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:KAI
Other - Middle Name:H
Other - Last Name:HAHN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DMD
Mailing Address - Street 1:738 SE MILLER ST
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97202-6340
Mailing Address - Country:US
Mailing Address - Phone:503-961-2021
Mailing Address - Fax:
Practice Address - Street 1:738 SE MILLER ST
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97202-6340
Practice Address - Country:US
Practice Address - Phone:503-961-2021
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-05
Last Update Date:2013-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORD9530122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist