Provider Demographics
NPI:1902266299
Name:CHAN, HSIANG LAN (DDS)
Entity Type:Individual
Prefix:
First Name:HSIANG LAN
Middle Name:
Last Name:CHAN
Suffix:
Gender:M
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:GENERAL PRACTICE RESIDENCY UNC SCHOOL OF
Mailing Address - Street 2:CB# 7450
Mailing Address - City:CHAPEL HILL
Mailing Address - State:NC
Mailing Address - Zip Code:27599-7450
Mailing Address - Country:US
Mailing Address - Phone:919-537-3571
Mailing Address - Fax:919-537-3586
Practice Address - Street 1:14300 GALLANT FOX LN STE 208
Practice Address - Street 2:
Practice Address - City:BOWIE
Practice Address - State:MD
Practice Address - Zip Code:20715-4033
Practice Address - Country:US
Practice Address - Phone:301-464-3500
Practice Address - Fax:301-262-3594
Is Sole Proprietor?:No
Enumeration Date:2016-02-29
Last Update Date:2023-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD162481223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice