Healthcare Provider Details

I. General information

NPI: 1225161136
Provider Name (Legal Business Name): JEFFREY A. HANIN DDS,INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/13/2007
Last Update Date: 09/08/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3370 E BROAD ST
COLUMBUS OH
43213-1008
US

IV. Provider business mailing address

3370 E BROAD ST
COLUMBUS OH
43213-1008
US

V. Phone/Fax

Practice location:
  • Phone: 614-237-2529
  • Fax: 614-237-4358
Mailing address:
  • Phone: 614-237-2529
  • Fax: 614-237-4358

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number
License Number State

VIII. Authorized Official

Name: DR. JEFFREY ALLEN HANIN
Title or Position: PRESIDENT
Credential: DDS
Phone: 614-237-2529