MEDICARE: DR. GRACE B HAN DDS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	122300000X	Dentist	052066	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1386850303
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. GRACE B HAN DDS

Provider Business Mailing Address
First Line	:	16410 NORTHERN BLVD STE 214
Second Line	:
City	:	FLUSHING
State	:	NY
Zip	:	11358-2668
Country	:	US
Telephone Number	:	718-321-7181
Fax Number	:

Provider Business Practice Location Address
First Line	:	16410 NORTHERN BLVD STE 214
Second Line	:
City	:	FLUSHING
State	:	NY
Zip	:	11358-2668
Country	:	US
Telephone Number	:	718-321-7181
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/15/2007
Last Update Date	:	03/13/2026

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