Individual provider Active NPI

Tate Hansen, DMD

  • General Practice Dentistry
  • Surprise, AZ
National Provider Identifier
1134036395
Registry record updated Aug 25, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
D012944 Issued in AZ
Practice address
17081 W Greenway Rd Ste 120
Surprise, AZ 85388-9612
Phone
(623) 546-8400
NPI assigned
Aug 25, 2026
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 25, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X D012944 AZ Primary

Addresses

Primary practice location

17081 W Greenway Rd Ste 120
Surprise, AZ 85388-9612

Mailing address

17081 W Greenway Rd Ste 120
Surprise, AZ 85388-9612
Phone (623) 546-8400

Medicare participation

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

NPI Registry JSON

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

{
    "created_epoch": "1787616000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787616000000",
    "number": "1134036395",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17081 W GREENWAY RD STE 120",
            "city": "SURPRISE",
            "state": "AZ",
            "postal_code": "853889612",
            "telephone_number": "623-546-8400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17081 W GREENWAY RD STE 120",
            "city": "SURPRISE",
            "state": "AZ",
            "postal_code": "853889612",
            "telephone_number": "623-546-8400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HANSEN",
        "first_name": "TATE",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2026-08-25",
        "last_updated": "2026-08-25",
        "certification_date": "2026-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AZ",
            "license": "D012944",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Surprise, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.