Provider Demographics
NPI:1750935649
Name:HANN, JOHN SCOTT (DMD)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:SCOTT
Last Name:HANN
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4555 KINGS ABBOT WAY
Mailing Address - Street 2:
Mailing Address - City:PEACHTREE CORNERS
Mailing Address - State:GA
Mailing Address - Zip Code:30092-1233
Mailing Address - Country:US
Mailing Address - Phone:404-759-5932
Mailing Address - Fax:
Practice Address - Street 1:1610 RIDENOUR BLVD NW STE 103
Practice Address - Street 2:
Practice Address - City:KENNESAW
Practice Address - State:GA
Practice Address - Zip Code:30152-4486
Practice Address - Country:US
Practice Address - Phone:678-905-6816
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-07-29
Last Update Date:2019-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GADN0158991223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice