Active NPI
Tate Hansen, DMD
- General Practice Dentistry
- Surprise, AZ
National Provider Identifier
1134036395
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- D012944
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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.