# DERICK W. HAHN D.D.S., PLLC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1447696752
- **Authorized official:** DR. DERICK WAYNE HAHN D.D.S. (DENTIST)
- **Authorized official phone:** (206) 778-0592

## Contact information

- **Practice address:** 1107 SW GRADY WAY, SUITE 200, RENTON, WA 98057-5217
- **Practice address phone:** (425) 226-9270
- **Practice address fax:** (425) 254-1129
- **Mailing address:** 720 S 38TH CT, RENTON, WA 98055-5894
- **Mailing address phone:** (206) 778-0592

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | DE60035932 | WA | Yes |

## Other

- **Enumeration date:** 05/14/2013
- **Last updated:** 05/14/2013

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 1699929167 | TYPE 1 NPI NUMBER | WA |