Individual provider Active NPI

Jerry C. Han

  • General Practice Dentistry
  • Kennewick, WA
National Provider Identifier
1891867875
Registry record updated Aug 7, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DE00008483 Issued in WA
Practice address
5000 W Clearwater Ave
Kennewick, WA 99336-1964
Phone
(509) 783-5000
Fax
(509) 783-8349
NPI assigned
Nov 14, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 7, 2026

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist) 1223S0112X 00008483 WA
General Practice Dentistry 1223G0001X DE00008483 WA Primary
Oral Medicine Dentistry 125Q00000X 00008483 WA
Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X 00008483 WA

Addresses

Primary practice location

5000 W Clearwater Ave
Kennewick, WA 99336-1964

Mailing address

5000 W Clearwater Ave
Kennewick, WA 99336-1910
Phone (509) 783-5000

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20150622002176 WA Order and Referring Only - DentistPractitioner - Dentist 8022109016

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DE00008483WAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Han, Rose and Rhoten, PLLC General Practice Current Accepting new patients

Locations

5000 W Clearwater Ave
Kennewick, WA 99336
Phone (509) 783-5000

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1163462400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1786060800000",
    "number": "1891867875",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5000 W CLEARWATER AVE",
            "city": "KENNEWICK",
            "state": "WA",
            "postal_code": "993361910",
            "telephone_number": "509-783-5000",
            "fax_number": "509-783-8349"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5000 W CLEARWATER AVE",
            "city": "KENNEWICK",
            "state": "WA",
            "postal_code": "993361964",
            "telephone_number": "509-783-5000",
            "fax_number": "509-783-8349"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAN",
        "first_name": "JERRY",
        "middle_name": "C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-14",
        "last_updated": "2026-08-07",
        "certification_date": "2026-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "WA",
            "license": "00008483",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WA",
            "license": "DE00008483",
            "primary": true
        },
        {
            "code": "125Q00000X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral Medicine",
            "state": "WA",
            "license": "00008483",
            "primary": false
        },
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "WA",
            "license": "00008483",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kennewick, WA

Sources for this page

Verify at the official NPI Registry.