NPIMap

Organization Active NPI

Wesley L Hanson, DDS, MSD, PS

  • Periodontics
  • Poulsbo, WA
National Provider Identifier
1013122076
Registry record updated Jun 14, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
PeriodonticsTaxonomy code 1223P0300X
License
DE6404 Issued in WA
Legal business name
WESLEY L HANSON, DDS, MSD, PS
Practice address
1040 NE Hostmark St
Suite 100a
Poulsbo, WA 98370-7337
Phone
(360) 779-4556
NPI assigned
May 13, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 14, 2013

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Wesley L Hanson Jr., D.D.S., M.S.D.
Title
President
Phone
(360) 779-4556

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PeriodonticsGroup: 193400000X SINGLE SPECIALTY GROUP 1223P0300X DE6404 WA Primary

Addresses

Primary practice location

1040 NE Hostmark St
Suite 100a
Poulsbo, WA 98370-7337

Mailing address

1040 NE Hostmark St
Suite 100a
Poulsbo, WA 98370-7337
Phone (360) 779-4556

National Provider Directory

National Provider Directory

Locations

1040 NE Hostmark St
Ste 100A
Poulsbo, WA 98370
Phone (360) 779-4556

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1179014400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1371168000000",
    "number": "1013122076",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1040 NE HOSTMARK ST",
            "address_2": "SUITE 100A",
            "city": "POULSBO",
            "state": "WA",
            "postal_code": "983707337",
            "telephone_number": "360-779-4556"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1040 NE HOSTMARK ST",
            "address_2": "SUITE 100A",
            "city": "POULSBO",
            "state": "WA",
            "postal_code": "983707337",
            "telephone_number": "360-779-4556"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WESLEY L HANSON, DDS, MSD, PS",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-13",
        "last_updated": "2013-06-14",
        "status": "A",
        "authorized_official_last_name": "HANSON",
        "authorized_official_first_name": "WESLEY",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "360-779-4556",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "D.D.S., M.S.D."
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Periodontics",
            "state": "WA",
            "license": "DE6404",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Poulsbo, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.