Provider Demographics
NPI:1720821275
Name:HAHN, CHRISTIAN TAYLOR
Entity type:Individual
Prefix:
First Name:CHRISTIAN
Middle Name:TAYLOR
Last Name:HAHN
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 1:715 MALL RING CIR STE 200
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89014-6667
Mailing Address - Country:US
Mailing Address - Phone:702-433-9200
Mailing Address - Fax:
Practice Address - Street 1:715 MALL RING CIR STE 200
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89014-6667
Practice Address - Country:US
Practice Address - Phone:702-433-9200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-13
Last Update Date:2024-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV80451223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice