Provider Demographics
NPI:1649470519
Name:INJOO HAN,D.D.S.,INC.
Entity type:Organization
Organization Name:INJOO HAN,D.D.S.,INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:INJOO
Authorized Official - Middle Name:
Authorized Official - Last Name:HAN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:530-622-3430
Mailing Address - Street 1:4355 GOLDEN CENTER DR
Mailing Address - Street 2:SUITE A
Mailing Address - City:PLACERVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95667-6260
Mailing Address - Country:US
Mailing Address - Phone:530-622-3430
Mailing Address - Fax:530-622-9733
Practice Address - Street 1:4355 GOLDEN CENTER DR
Practice Address - Street 2:SUITE A
Practice Address - City:PLACERVILLE
Practice Address - State:CA
Practice Address - Zip Code:95667-6260
Practice Address - Country:US
Practice Address - Phone:530-622-3430
Practice Address - Fax:530-622-9733
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-19
Last Update Date:2007-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA48283305R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305R00000XManaged Care OrganizationsPreferred Provider Organization