Derick W. Hahn D.D.S., PLLC

Primary specialty

DentistTaxonomy code 122300000X

License

DE60035932 Issued in WA

Legal business name

DERICK W. HAHN D.D.S., PLLC

Practice address

1107 SW Grady Way
Suite 200
Renton, WA 98057-5217

Phone

(425) 226-9270

Fax

(425) 254-1129

NPI assigned

May 14, 2013

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Derick Wayne Hahn, D.D.S.

Title

Dentist

Phone

(206) 778-0592

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1368489600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1368489600000",
    "number": "1447696752",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "720 S 38TH CT",
            "city": "RENTON",
            "state": "WA",
            "postal_code": "980555894",
            "telephone_number": "206-778-0592"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1107 SW GRADY WAY",
            "address_2": "SUITE 200",
            "city": "RENTON",
            "state": "WA",
            "postal_code": "980575217",
            "telephone_number": "425-226-9270",
            "fax_number": "425-254-1129"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DERICK W. HAHN D.D.S., PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-05-14",
        "last_updated": "2013-05-14",
        "status": "A",
        "authorized_official_last_name": "HAHN",
        "authorized_official_first_name": "DERICK",
        "authorized_official_middle_name": "WAYNE",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "206-778-0592",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "WA",
            "license": "DE60035932",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TYPE 1 NPI NUMBER",
            "identifier": "1699929167",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Laura Denman, CNM
• Dentistry @ Renton
• Gwendolyn Yvonne Denton, LMP
• Gabriela Depusoy, ARNP
• Katia Rose Dergham, CGC
• Marilyn Carter Derksen, C.N.M.
• Bria Nicole Deruyck
• Michele A Despreaux
• Harshpreet Devi
• Elizabeth Raleigh Devine, MSW, LICSW, CDP

• Dentist in Renton, WA
• Providers in Renton, WA by specialty
• Dentist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.