Michael B Han, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

102083 Issued in CA

Practice address

5258 Beach Blvd
Suite a
Buena Park, CA 90621

Phone

(714) 523-2828

Fax

(509) 664-4585

NPI assigned

Aug 16, 2013

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Boram Charles Han Former name

Medicare fee-for-service enrollment

Enrolled in WA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1376611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1581465600000",
    "number": "1699108399",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5258 BEACH BLVD",
            "address_2": "SUITE A",
            "city": "BUENA PARK",
            "state": "CA",
            "postal_code": "90621",
            "telephone_number": "714-523-2828",
            "fax_number": "509-664-4585"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5258 BEACH BLVD",
            "address_2": "SUITE A",
            "city": "BUENA PARK",
            "state": "CA",
            "postal_code": "90621",
            "telephone_number": "714-523-2828",
            "fax_number": "509-664-4585"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAN",
        "first_name": "MICHAEL",
        "middle_name": "B",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-08-16",
        "last_updated": "2020-02-12",
        "certification_date": "2020-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "PA",
            "license": "DS039728",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "102083",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BORAM",
            "last_name": "HAN",
            "middle_name": "CHARLES",
            "credential": "DDS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Janeal Hall
• Hamsoa Oc Acupuncture, Inc.
• Dae Youn Han
• Dong Gwon Han, DC, DAOM, LAC
• Jonghyun Han, L.AC
• Pill Han
• Richard Han, M.D.
• Soo Hee Han, L.AC
• Hana Medical Group, Inc.
• Sandy Hanna

• General Practice Dentistry in Buena Park, CA
• Providers in Buena Park, CA by specialty
• General Practice Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.