Provider Demographics
NPI:1881994853
Name:XIANG NING HAN D.D.S DENTAL CORPORATION
Entity type:Organization
Organization Name:XIANG NING HAN D.D.S DENTAL CORPORATION
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DENTIST
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 1:17337 ARROW BLVD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:FONTANA
Mailing Address - State:CA
Mailing Address - Zip Code:92335-3950
Mailing Address - Country:US
Mailing Address - Phone:909-357-1000
Mailing Address - Fax:909-357-0102
Practice Address - Street 1:17337 ARROW BLVD
Practice Address - Street 2:SUITE 200
Practice Address - City:FONTANA
Practice Address - State:CA
Practice Address - Zip Code:92335-3950
Practice Address - Country:US
Practice Address - Phone:909-357-1000
Practice Address - Fax:909-357-0102
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:XIANG NING HAN D.D.S. DENTAL CORPORATION
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2010-10-25
Last Update Date:2010-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA484591223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty