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General NPI Number Information
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NPI Number | 1265858021
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Entity Type | Organization
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Legal Business Name | JOHN HAN D.D.S., P.C.
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Dates
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Enumeration Date | 03/17/2014
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Last Update Date | 03/17/2014
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Provider Practice Location Address
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Address Line | 6120 BRANDON AVE STE 114
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City | SPRINGFIELD
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State | VA
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Zip | 22150-2504
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Country | US
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Telephone | 703-992-7100
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Fax | 703-992-7137
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Provider Business Mailing Address
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Address Line | 6120 BRANDON AVE STE 114
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City | SPRINGFIELD
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State | VA
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Zip | 22150-2504
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Country | US
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Telephone | 703-992-7100
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Fax | 703-992-7137
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JOHN HAN
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Credential | DDS
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Telephone | 703-992-5842
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number | 0401410533
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License Number State | VA
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