Joshua Hassan, D.M.D

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

License

1001750-15 Issued in WI

Practice address

2100 Miller Park Way
West Milwaukee, WI 53219-1641

Phone

(908) 812-2220

NPI assigned

Mar 4, 2016

Last updated

Apr 17, 2018By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1457049600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1523923200000",
    "number": "1184084055",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3012 W JARVIS AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606451112",
            "telephone_number": "908-812-2220"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2100 MILLER PARK WAY",
            "city": "WEST MILWAUKEE",
            "state": "WI",
            "postal_code": "532191641",
            "telephone_number": "908-812-2220"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2829 N Lincoln Ave",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606576932",
            "country_code": "US",
            "telephone_number": "908-812-2220",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "10155 Washington Ave",
            "address_purpose": "LOCATION",
            "city": "Sturtevant",
            "state": "WI",
            "postal_code": "531771645",
            "country_code": "US",
            "telephone_number": "908-812-2220",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HASSAN",
        "first_name": "JOSHUA",
        "credential": "D.M.D",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-03-04",
        "last_updated": "2018-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IL",
            "license": "319.020434",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IL",
            "license": "019.031082",
            "primary": false
        },
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "WI",
            "license": "1001750-15",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Trista M Grudzinski, LPN
• Audra L Hale, APNP
• Kourtney K Haller, RN
• Hanger Prosthetics & Orthotics East Inc (Hanger Clinic)
• Mia D Hardison, RN
• Jalyn N Herd, LPN
• Alter Faye Hughes, RN
• Regina Hunter, MSE,CSAC
• Ami Inoue, D.D.S.
• Renee Rochelle Johnson, PHARMD

• Periodontics in West Milwaukee, WI
• Providers in West Milwaukee, WI by specialty
• Periodontics in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2018; 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.