HAN, JANG, SON & SUH, DENTAL GROUP, PC (NPI# 1275781932) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1275781932 |
| Entity Type | Organization |
| Organization Name | HAN, JANG, SON & SUH, DENTAL GROUP, PC |
| Other Organization Name | WILSHIRE PARK DENTAL GROUP |
| Practice Address |
3700 Wilshire Blvd 780 Los Angeles CA 90010-2901 |
| Practice Telephone | 2133807900 |
| Practice Fax Number | 2133823454 |
| Mailing Telephone | 2133807900 |
| Mailing Fax Number | 2133823454 |
| Enumeration Date | 2008-09-05 |
| Last Update Date | 2008-09-05 |
| Authorized Official Name | DR. LEE JAY HARRIS (CORPORATE SEC./ EXEC. DIRECTOR) |
| Authorized Official Telephone | 2133807900 |
| Authorized Official Credential | DDS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 122300000X | Dentist | Dental Providers | ||
| N | 1223G0001X |
Dentist Specialization: General Practice |
Dental Providers | ||
| N | 1223P0221X |
Dentist Specialization: Pediatric Dentistry |
Dental Providers | ||
| N | 1223P0700X |
Dentist Specialization: Prosthodontics |
Dental Providers | ||
| N | 1223X0400X |
Dentist Specialization: Orthodontics and Dentofacial Orthopedics |
Dental Providers | ||
| Y | 1223P0300X |
Dentist Specialization: Periodontics |
Dental Providers |
| Other Name | Type Code |
|---|---|
| Wilshire Park Dental Group | Doing Business As Name - Organization |
| Street Address |
3700 WILSHIRE BLVD 780 |
| City | LOS ANGELES |
| State | CA |
| Zip Code | 90010-2901 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780604264 | Boniface Tsobnang | Durable Medical Equipment & Medical Supplies | 3700 Wilshire Blvd, Suite 1010, Los Angeles, CA 90010-2901 | 2006-07-20 |
| 1912438516 | Fatima Medical Center Inc | Family Medicine | 3700 Wilshire Blvd, Suite 422, Los Angeles, CA 90010-2901 | 2017-03-24 |
| 1871032839 | Windsor Medical Center Inc | Family Medicine | 3700 Wilshire Blvd, 408, Los Angeles, CA 90010-2901 | 2017-02-23 |
| 1013362177 | Fatima Medical Center | Family Medicine | 3700 Wilshire Blvd, 422, Los Angeles, CA 90010-2901 | 2016-04-26 |
| 1346626421 | Donald Kwon | Dentist | 3700 Wilshire Blvd, Suite 400, Los Angeles, CA 90010-2901 | 2015-07-30 |
| 1194118398 | Watson Medical Center Inc | Family Medicine | 3700 Wilshire Blvd, Suite 422, Los Angeles, CA 90010-2901 | 2015-03-12 |
| 1962809400 | Skin Aesthetic Medical, Inc | Clinic/Center | 3700 Wilshire Blvd, Suite 310, Los Angeles, CA 90010-2901 | 2014-11-26 |
| 1356753545 | Kwon Orthodontics | Dentist | 3700 Wilshire Blvd, Suite #400, Los Angeles, CA 90010-2901 | 2014-05-22 |
| 1376965772 | Crystal Medical Center Inc | Family Medicine | 3700 Wilshire Blvd, Suite 441, Los Angeles, CA 90010-2901 | 2014-01-20 |
| 1013276203 | Camden Medical Center Inc | Family Medicine | 3700 Wilshire Blvd, Suite 422, Los Angeles, CA 90010-2905 | 2012-05-09 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205454204 | Sage Minds | Psychiatry & Neurology | 3860 Wilshire Blvd, P04-1188, Los Angeles, CA 90010 | 2020-07-07 |
| 1629602750 | Shalva, A Psychology Corporation | Counselor | 4221 Wilshire Boulevlard, Suite 170b, Los Angeles, CA 90010 | 2020-02-27 |
| 1609346287 | Leticia Arteaga | Marriage & Family Therapist | 3580 Wilshire Blvd Suite 800, Los Angeles, CA 90010 | 2018-11-27 |
| 1891265559 | Maria Nguyen | Case Manager/Care Coordinator | 3424 Wilshire Blvd Ste 1000, Los Angeles, CA 90010 | 2018-11-26 |
| 1568955474 | Cherie Emi Okada | Student in an Organized Health Care Education/Training Program | 358 Wilshire Blvd, Suite 2000, Los Angeles, CA 90010 | 2018-06-14 |
| 1780101832 | Bj Park, Chiropractic | Acupuncturist | 3020 Wilshire Blvd., Suite 220, Los Angeles, CA 90010 | 2017-08-29 |
| 1952828188 | Karin Alm | Case Manager/Care Coordinator | 3580 Wilshire Blvd., Suite 2000, Los Angeles, CA 90010 | 2017-08-28 |
| 1295257111 | Freddy Pablo | Rehabilitation Practitioner | 3580 Wilshire Blvd., Ste. 800, Los Angeles, CA 90010 | 2017-07-12 |
| 1770032690 | Astghik Harutyunyan | Special Hospital | 3699 Wilshire Blve, Los Angeles, CA 90010 | 2016-10-04 |
| 1629446281 | Praveena Chinniah | Behavioral Analyst | 4221 Wilshire Blvd., Suite 300a, Los Angeles, CA 90010 | 2015-09-11 |
| Find all providers in zip 90010 | ||||
| Taxonomy Code | 1223P0300X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Periodontics |
| That specialty of dentistry which encompasses the prevention, diagnosis and treatment of diseases of the supporting and surrounding tissues of the teeth or their substitutes and the maintenance of the health, function and esthetics of these structures and tissues. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063057008 | Robert Lacrampe | Dentist | 880 W 1st St Apt 526, Los Angeles, CA 90012-2473 | 2019-11-13 |
| 1891136768 | Mahdad Nassiri | Dentist | 11740 Wilshire Blvd, Apt A1008, Los Angeles, CA 90025-6536 | 2013-07-08 |
| 1821336116 | Soheil Levi | Dentist | 31 Oakmont Dr, Los Angeles, CA 90049-1901 | 2013-01-22 |
| 1669716437 | Flavia Pirih | Dentist | 100 Ucla Medical Plaza, Suite 320, Los Angeles, CA 90095 | 2012-11-19 |
| 1932453198 | Marwa B Abulhasan | Dentist | 925 W 34th St # 108, Los Angeles, CA 90089-3075 | 2012-11-08 |
| 1588925010 | One Dental Specialties | Dentist | 621 S Western Ave, Suite 116, Los Angeles, CA 90005-3039 | 2012-05-31 |
| 1144591462 | Jacob Elisha | Dentist | 11600 Wilshire Blvd Ste 504, Los Angeles, CA 90025-1788 | 2012-01-18 |
| 1912278417 | Chloe Lea Cohen | Dentist | 655 S Hope St, Suite #1402, Los Angeles, CA 90017-3237 | 2012-01-16 |
| 1568695922 | Aleksander Jovanovic | Dentist | 12217 W Pico Blvd, Los Angeles, CA 90064-1134 | 2009-09-01 |
| 1649427972 | Natasha Yashar | Dentist | 13529 Bayliss Rd, Los Angeles, CA 90049-1812 | 2008-08-18 |
| Find all providers in LOS ANGELES | ||||
| City | LOS ANGELES |
| Zip Code | 90010 |
Please comment or provide details below to improve the information on HAN, JANG, SON & SUH, DENTAL GROUP, PC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.