MEDICARE: DR. ERIKA RAE HAHN DDS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	09402	IA

General Provider Information

NPI Number	:	1518487826
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ERIKA RAE HAHN DDS

Provider Business Mailing Address
First Line	:	3115 WESTPOINT CIRCLE
Second Line	:
City	:	RIVERSIDE
State	:	IA
Zip	:	52327
Country	:	US
Telephone Number	:	641-430-6642
Fax Number	:

Provider Business Practice Location Address
First Line	:	2201 COLUMBUS ST
Second Line	:
City	:	COLUMBUS CITY
State	:	IA
Zip	:	52737-9000
Country	:	US
Telephone Number	:	319-728-8100
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/27/2017
Last Update Date	:	06/27/2017

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