Provider Demographics
NPI:1235958695
Name:DW HAN PLLC
Entity type:Organization
Organization Name:DW HAN PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF OPERATIONS
Authorized Official - Prefix:
Authorized Official - First Name:CHELSEA
Authorized Official - Middle Name:
Authorized Official - Last Name:NUEVO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:907-301-6112
Mailing Address - Street 1:4140 FACTORIA BLVD SE STE 1A
Mailing Address - Street 2:
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98006-5261
Mailing Address - Country:US
Mailing Address - Phone:425-222-1234
Mailing Address - Fax:
Practice Address - Street 1:4140 FACTORIA BLVD SE STE 1A
Practice Address - Street 2:
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98006-5261
Practice Address - Country:US
Practice Address - Phone:425-222-1234
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-10-03
Last Update Date:2024-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Multi-Specialty
No1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty