Active NPI
Liban Hassan
- Dentist
- Rochester, MN
National Provider Identifier
1215722442
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- D15299
- Practice address
- 1290 Salem Rd SW # 10
Rochester, MN 55902-4210 - Phone
- (507) 686-6968
- NPI assigned
- Apr 9, 2025
- Last updated
- Jun 5, 2025
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Dentist | 122300000X | D15299 | MN | Primary |
Addresses
Primary practice location
1290 Salem Rd SW # 10
Rochester, MN 55902-4210
Mailing address
248 Oak Dr
Eagle Lake, MN 56024-3404
Phone (507) 491-0668
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| D15299 | MN | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1744156800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1749081600000",
"number": "1215722442",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "248 OAK DR",
"city": "EAGLE LAKE",
"state": "MN",
"postal_code": "560243404",
"telephone_number": "507-491-0668"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1290 SALEM RD SW # 10",
"city": "ROCHESTER",
"state": "MN",
"postal_code": "559024210",
"telephone_number": "507-686-6968"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HASSAN",
"first_name": "LIBAN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2025-04-09",
"last_updated": "2025-06-05",
"certification_date": "2025-06-05",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "MN",
"license": "D15299",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Rochester, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.