Jace Andrew Hanisch, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

D1440 Issued in SD

Practice address

20 19TH St SE # 3938
Watertown, SD 57201-3938

Phone

(605) 886-2805

NPI assigned

May 27, 2024

Sex

Male

Sole proprietor

No

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

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1716768000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716768000000",
    "number": "1083454243",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 19TH ST SE # 3938",
            "city": "WATERTOWN",
            "state": "SD",
            "postal_code": "572013938",
            "telephone_number": "605-886-2805"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 19TH ST SE # 3938",
            "city": "WATERTOWN",
            "state": "SD",
            "postal_code": "572013938",
            "telephone_number": "605-886-2805"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HANISCH",
        "first_name": "JACE",
        "middle_name": "ANDREW",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-05-27",
        "last_updated": "2024-05-27",
        "certification_date": "2024-05-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "SD",
            "license": "D1440",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tucker William Gross, RDH
• Terri L Groves, PA-C
• Jennifer D Guest, MS, LPC
• Denise M Hall, DC
• Deb A Hamer, CCDC III NCGC
• Hunter John Hansen, PT, DPT
• Jennifer Hansen
• Hanson- Moran Eye Clinic PC
• Hanson-Moran Eye Clinic PC
• Bernie HP Hanson, MD

• General Practice Dentistry in Watertown, SD
• Providers in Watertown, SD by specialty
• General Practice Dentistry in South Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2024; 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.