Gentry Michael Hansen, DMD, MD

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

09513 Issued in IA

Practice address

5828 Sunnybrook Dr
Sioux City, IA 51106-4253

Phone

(712) 823-9654

Fax

(712) 823-9008

NPI assigned

May 1, 2012

Last updated

Mar 7, 2024By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 5

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Previously, effective Oct 4, 2022 through Oct 4, 2026

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Oral Surgery Assocates, P.C.

  • Oral and Maxillofacial Surgery (Dentist)
  • Dakota Dunes, SD
  • NPI 1548304710
  NPD (past)

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

{
    "created_epoch": "1335830400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709769600000",
    "number": "1235497975",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5828 SUNNYBROOK DR",
            "city": "SIOUX CITY",
            "state": "IA",
            "postal_code": "511064253",
            "telephone_number": "712-823-9654",
            "fax_number": "712-823-9008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5828 SUNNYBROOK DR",
            "city": "SIOUX CITY",
            "state": "IA",
            "postal_code": "511064253",
            "telephone_number": "712-823-9654",
            "fax_number": "712-823-9008"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HANSEN",
        "first_name": "GENTRY",
        "middle_name": "MICHAEL",
        "credential": "DMD, MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-05-01",
        "last_updated": "2024-03-07",
        "certification_date": "2024-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "SD",
            "license": "D1197",
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "IA",
            "license": "09513",
            "primary": true
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "IA",
            "license": "45169",
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "SD",
            "license": "11002",
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "TX",
            "license": "32567",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Hanger Prosthetics & Orthotics East Inc (Hanger Clinic)
• Denise S Hanisch, MD
• Matti Hannah
• Hanno Therapy Services Inc
• Danika Leigh Hansen, PMHNP
• Gracie Taylor Hansen, PHD
• Kristi Jo Hansen, P.A.
• Melissa Hansen, PHARMD
• Christine Anne Hanson-Harder, OTR/L
• Bethany Lynn Hanson, OTD, OTR/L

• Oral and Maxillofacial Surgery (Dentist) in Sioux City, IA
• Providers in Sioux City, IA by specialty
• Oral and Maxillofacial Surgery (Dentist) in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.