Individual provider Active NPI

Nathaniel Raphael Hassan

  • Dentist
  • Palmdale, CA
National Provider Identifier
1043768773
Registry record updated Jun 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
100796 Issued in CA
Practice address
38209 47TH St E Ste E
Palmdale, CA 93552-3113
Phone
(661) 236-0046
NPI assigned
Sep 12, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 18, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 100796 CA Primary

Addresses

Primary practice location

38209 47TH St E Ste E
Palmdale, CA 93552-3113

Mailing address

12317 Addison St.
Los Angeles, CA 91607
Phone (818) 915-3894

Other practice location 1

18500 Via Princessa Ste 1
Santa Clarita, CA 91387-8325
Phone (661) 298-1100

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
100796CAMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Yasmin Easley Dental Corporation Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1473638400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750204800000",
    "number": "1043768773",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12317 ADDISON ST.",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "91607",
            "telephone_number": "818-915-3894",
            "fax_number": "818-915-3894"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "38209 47TH ST E STE E",
            "city": "PALMDALE",
            "state": "CA",
            "postal_code": "935523113",
            "telephone_number": "661-236-0046"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "18500 Via Princessa Ste 1",
            "address_purpose": "LOCATION",
            "city": "Santa Clarita",
            "state": "CA",
            "postal_code": "913878325",
            "country_code": "US",
            "telephone_number": "661-298-1100",
            "fax_number": "661-298-1108",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HASSAN",
        "first_name": "NATHANIEL",
        "middle_name": "RAPHAEL",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-09-12",
        "last_updated": "2025-06-18",
        "certification_date": "2025-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "100796",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palmdale, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2025; 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.