Organization Active NPI

Hansen Family Dental PLLC

  • General Practice Dentistry
  • Pasco, WA
National Provider Identifier
1114045937
Registry record updated May 14, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
10263 Issued in WA
Legal business name
HANSEN FAMILY DENTAL PLLC
Practice address
6615 W Argent Rd
Pasco, WA 99301-1905
Phone
(509) 547-9951
Fax
(509) 547-3008
NPI assigned
Mar 27, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 14, 2021

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

Authorized official

Name
James R Hansen, DMDNPI 1184856999
Title
Owner
Phone
(509) 547-9951

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223G0001X 10263 WA Primary

Addresses

Primary practice location

6615 W Argent Rd
Pasco, WA 99301-1905

Mailing address

6615 W Argent Rd
Pasco, WA 99301-1905
Phone (509) 547-9951

Other identifiers 1

IdentifierTypeStateIssuer
5052253MedicaidWA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210512002602 WA Part B Supplier - Clinic/Group Practice 3476962903 Receives reassigned benefits from 4 practitioners
Practice locations: Pasco, WA

National Provider Directory

National Provider Directory

Locations

6615 W Argent Rd
Pasco, WA 99301
Phone (509) 547-9951

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1174953600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1620950400000",
    "number": "1114045937",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6615 W ARGENT RD",
            "city": "PASCO",
            "state": "WA",
            "postal_code": "993011905",
            "telephone_number": "509-547-9951",
            "fax_number": "509-547-3008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6615 W ARGENT RD",
            "city": "PASCO",
            "state": "WA",
            "postal_code": "993011905",
            "telephone_number": "509-547-9951",
            "fax_number": "509-547-3008"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HANSEN FAMILY DENTAL PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-27",
        "last_updated": "2021-05-14",
        "certification_date": "2021-05-14",
        "status": "A",
        "authorized_official_last_name": "HANSEN",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "509-547-9951",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "WA",
            "license": "10263",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5052253",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pasco, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.