Healthcare Provider Details

I. General information

NPI: 1629914734
Provider Name (Legal Business Name): JENNA HAHN DMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/28/2026
Last Update Date: 04/28/2026
Certification Date: 04/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

385 PROSPECT AVE STE 304
HACKENSACK NJ
07601-2570
US

IV. Provider business mailing address

2030 HUDSON ST APT 1033
FORT LEE NJ
07024-7225
US

V. Phone/Fax

Practice location:
  • Phone: 201-425-9580
  • Fax:
Mailing address:
  • Phone: 440-799-1595
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223E0200X
TaxonomyEndodontics
License Number22D103144900
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: