Timothy Hansen

Primary specialty

DentistTaxonomy code 122300000X

License

12885953-9922 Issued in UT

Practice address

2592 S 5600 W Ste 102
West Valley City, UT 84120-1274

Phone

(801) 613-2904

NPI assigned

Jun 7, 2022

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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

• Simply Smiles Dental Utah

  • Dental Clinic/Center
  • West Valley City, UT
  • NPI 1124664834
  NPD

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

{
    "created_epoch": "1654560000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654560000000",
    "number": "1245969054",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "695 WINDSOR CT",
            "city": "ALPINE",
            "state": "UT",
            "postal_code": "840041934",
            "telephone_number": "385-219-0372"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2592 S 5600 W STE 102",
            "city": "WEST VALLEY CITY",
            "state": "UT",
            "postal_code": "841201274",
            "telephone_number": "801-613-2904"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HANSEN",
        "first_name": "TIMOTHY",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-06-07",
        "last_updated": "2022-06-07",
        "certification_date": "2022-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "UT",
            "license": "12885953-9922",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Breeann Berger Hamp, CSW
• Hanai Family Services LLC
• Andrew Hansen, PA-C
• Kyle D Hansen, PHARMD
• Terry Milo Hansen, OD
• Jamie Elise Hanson, M.D.
• Christina Kathryn Harden, LCSW
• Glenna J Hardy, RN
• Harmon City Inc
• Alisa L Harmon, MA, ACMHC, NCC

• Dentist in West Valley City, UT
• Providers in West Valley City, UT by specialty
• Dentist in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2022; 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.