Provider Demographics
NPI:1184047177
Name:HAN, PEARL LEE (DDS)
Entity type:Individual
Prefix:
First Name:PEARL
Middle Name:LEE
Last Name:HAN
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:535 PLANDOME RD UNIT 5
Mailing Address - Street 2:
Mailing Address - City:MANHASSET
Mailing Address - State:NY
Mailing Address - Zip Code:11030-1974
Mailing Address - Country:US
Mailing Address - Phone:516-627-5442
Mailing Address - Fax:516-570-6656
Practice Address - Street 1:535 PLANDOME RD UNIT 5
Practice Address - Street 2:
Practice Address - City:MANHASSET
Practice Address - State:NY
Practice Address - Zip Code:11030-1974
Practice Address - Country:US
Practice Address - Phone:516-627-5442
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-01-27
Last Update Date:2024-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0580321223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice