Provider Demographics
NPI:1528947660
Name:HANNA, JOHN EMAD
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:EMAD
Last Name:HANNA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:840 S MAGNOLIA AVE UNIT 1302
Mailing Address - Street 2:
Mailing Address - City:ONTARIO
Mailing Address - State:CA
Mailing Address - Zip Code:91762-4774
Mailing Address - Country:US
Mailing Address - Phone:818-300-9439
Mailing Address - Fax:
Practice Address - Street 1:840 S MAGNOLIA AVE UNIT 1302
Practice Address - Street 2:
Practice Address - City:ONTARIO
Practice Address - State:CA
Practice Address - Zip Code:91762-4774
Practice Address - Country:US
Practice Address - Phone:818-300-9439
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-09-02
Last Update Date:2025-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA39020000X1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice