Healthcare Provider Details

I. General information

NPI: 1457737454
Provider Name (Legal Business Name): ERIC S HAN DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/03/2015
Last Update Date: 02/16/2025
Certification Date: 02/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3408 VERONA DR
CORINTH TX
76210-2863
US

IV. Provider business mailing address

3408 VERONA DR
CORINTH TX
76210-2863
US

V. Phone/Fax

Practice location:
  • Phone: 214-831-9105
  • Fax: 214-614-7484
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number38164
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code1223D0004X
TaxonomyDental Anesthesiology
License Number11925
License Number StateCT
# 3
Primary TaxonomyN
Taxonomy Code1223D0004X
TaxonomyDental Anesthesiology
License NumberDN1856970
License Number StateMA
# 4
Primary TaxonomyY
Taxonomy Code1223D0004X
TaxonomyDental Anesthesiology
License Number38164
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: