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General NPI Number Information
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NPI Number | 1962902478
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Entity Type | Individual
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Provider Name | SUNG HYON HAN DMD
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Gender | Male
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Dates
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Enumeration Date | 02/20/2018
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Last Update Date | 05/01/2025
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Provider Practice Location Address
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Address Line | 1110 STATE ROUTE 55 STE 107
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City | LAGRANGEVILLE
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State | NY
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Zip | 12540-5048
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Country | US
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Telephone | 845-320-5262
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Fax |
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Provider Business Mailing Address
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Address Line | 64 MIDLAND PL APT 2413
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City | TUCKAHOE
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State | NY
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Zip | 10707-4249
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Country | US
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Telephone | 917-744-7129
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223S0112X
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Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
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License Number | 13795
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License Number State | CT
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Taxonomy #2
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Taxonomy Code | 1223S0112X
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Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
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License Number | 063245
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License Number State | NY
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