Otto Julius Hanssen, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DE00005262 Issued in WA

Practice address

21515 State Route 410 E
Suite a
Bonney Lake, WA 98391-4100

Phone

(253) 826-9000

Fax

(253) 826-0328

NPI assigned

Jan 24, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Mar 24, 2016 through Mar 24, 2028

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Ojh Clinic #6 Inc.

  • General Practice Dentistry
  • Bonney Lake, WA
  • NPI 1699820019
  NPD (past) Authorized official
• Bonney Lake Family Dentistry, PLLC

  • General Practice Dentistry
  • Bonney Lake, WA
  • NPI 1548018526
  NPD (past)

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

{
    "created_epoch": "1169596800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1043365935",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21515 STATE ROUTE 410 E",
            "address_2": "SUITE A",
            "city": "BONNEY LAKE",
            "state": "WA",
            "postal_code": "983914100",
            "telephone_number": "253-826-9000",
            "fax_number": "253-826-0328"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21515 STATE ROUTE 410 E",
            "address_2": "SUITE A",
            "city": "BONNEY LAKE",
            "state": "WA",
            "postal_code": "983914100",
            "telephone_number": "253-826-9000",
            "fax_number": "253-826-0328"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HANSSEN",
        "first_name": "OTTO",
        "middle_name": "JULIUS",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-24",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WA",
            "license": "DE00005262",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Daniel J Hahn, PA-C
• Thuy-Trang T Hahn, ARNP
• Linden Hale, MS, RD
• Kristine Hannah
• Emily A. Hansen, OTR/L
• Tiffany Hardy
• Nicole Tatiana Hawe, OTR/L
• Ralph Donald Hawkins, DDS
• Nishy Kaur Hayre
• Eric Tony Hecimovich, DC

• General Practice Dentistry in Bonney Lake, WA
• Providers in Bonney Lake, WA by specialty
• General Practice Dentistry in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.