Active NPI
Thomas Walter Hansen, DDS
- Dentist
- Dawson, MN
National Provider Identifier
1164540910
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 9171
- Practice address
- 792 6TH St
Dawson, MN 56232-0456 - Phone
- (320) 769-4756
- Fax
- (320) 769-4756
- NPI assigned
- Mar 27, 2007
- Last updated
- Jul 8, 2007
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Dentist | 122300000X | 9171 | MN | Primary |
Addresses
Primary practice location
792 6TH St
Dawson, MN 56232-0456
Mailing address
PO Box 456
792 6TH St
Dawson, MN 56232-0456
Phone (320) 769-4756
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MN
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160829003145 | MN | Order and Referring Only - Dentist | 2365737384 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1174953600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1164540910",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 456",
"address_2": "792 6TH ST",
"city": "DAWSON",
"state": "MN",
"postal_code": "562320456",
"telephone_number": "320-769-4756",
"fax_number": "320-769-4756"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "792 6TH ST",
"city": "DAWSON",
"state": "MN",
"postal_code": "562320456",
"telephone_number": "320-769-4756",
"fax_number": "320-769-4756"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HANSEN",
"first_name": "THOMAS",
"middle_name": "WALTER",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-03-27",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "MN",
"license": "9171",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Dawson, MN
- Divine House II Inc.
- Krystle Marie Drietz, CNP, PMHNP
- Renae A Durfee, FNP-C
- Facing New Horizons, Inc.
- Larry Jay Grong, D.O.
- Lindsey Anne Hanson, M.D., M.P.H
- Kase Allen Jacobs, CNP
- Johnson Memorial Health Services (Johnson Memorial Hospital)
- Johnson Memorial Health Services (Johnson Memorial Home Care)
- Johnson Memorial Health Services (Dawson Clinic)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.