Active NPI
Jason Han, DDS
- Dentist
- Los Angeles, CA
National Provider Identifier
1114016672
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 46067
- Practice address
- 311 E Winston Street
Los Angeles Mission Community Clinic
Los Angeles, CA 90013 - Phone
- (213) 893-1960
- Fax
- (213) 893-1962
- NPI assigned
- Oct 12, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 46067 | CA | Primary |
Addresses
Primary practice location
311 E Winston Street
Los Angeles Mission Community Clinic
Los Angeles, CA 90013
Mailing address
20138 Devonshire St
Chatsworth, CA 91311
Phone (818) 448-0855
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| EAP70948F | Other | CA | EAPC |
| CMM70948F | Medicaid | CA |
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 |
|---|---|---|---|
| 46067 | CA | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1160611200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1114016672",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "20138 DEVONSHIRE ST",
"city": "CHATSWORTH",
"state": "CA",
"postal_code": "91311",
"telephone_number": "818-448-0855"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "311 E WINSTON STREET",
"address_2": "LOS ANGELES MISSION COMMUNITY CLINIC",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "90013",
"telephone_number": "213-893-1960",
"fax_number": "213-893-1962"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HAN",
"first_name": "JASON",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-10-12",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "CA",
"license": "46067",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "EAPC",
"identifier": "EAP70948F",
"state": "CA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "CMM70948F",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Los Angeles, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.