Healthcare Provider Details

I. General information

NPI: 1851219489
Provider Name (Legal Business Name): DONG HAN DMD PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/09/2026
Last Update Date: 07/09/2026
Certification Date: 07/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11102 SUNRISE BLVD E STE 101
SOUTH HILL WA
98374-8846
US

IV. Provider business mailing address

11102 SUNRISE BLVD E STE 101
SOUTH HILL WA
98374-8846
US

V. Phone/Fax

Practice location:
  • Phone: 253-235-9998
  • Fax:
Mailing address:
  • Phone: 253-235-9998
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License Number
License Number State

VIII. Authorized Official

Name: DONGWU HAN
Title or Position: OWNER
Credential:
Phone: 253-235-9998