Active NPI
Richard Roger Han, DDS
- Dentist
- Rancho Cordova, CA
National Provider Identifier
1083864615
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- DE60058989
- Practice address
- 11155 International Dr
Rancho Cordova, CA 95670-6096 - Phone
- (360) 951-2452
- NPI assigned
- Sep 18, 2008
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 64370 | CA | |
| Dentist | 122300000X | DE60058989 | WA | Primary |
Addresses
Primary practice location
11155 International Dr
Rancho Cordova, CA 95670-6096
Mailing address
9609 Pasture Rose Way
Elk Grove, CA 95624-6071
Phone (360) 951-2452
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DE60058989 | WA | MD | Dentist |
| 64370 | CA | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1221696000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1442275200000",
"number": "1083864615",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9609 PASTURE ROSE WAY",
"city": "ELK GROVE",
"state": "CA",
"postal_code": "956246071",
"telephone_number": "360-951-2452"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11155 INTERNATIONAL DR",
"city": "RANCHO CORDOVA",
"state": "CA",
"postal_code": "956706096",
"telephone_number": "360-951-2452"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HAN",
"first_name": "RICHARD",
"middle_name": "ROGER",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2008-09-18",
"last_updated": "2015-09-15",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "CA",
"license": "64370",
"primary": false
},
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "WA",
"license": "DE60058989",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Rancho Cordova, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.