NPIMap

Organization Active NPI

Guy M Hanson DDS PA

  • Dentist
  • Boise, ID
National Provider Identifier
1255590105
Registry record updated Jun 5, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
D1850 Issued in ID
Legal business name
GUY M HANSON DDS PA
Doing business as
Idaho Dental Wellness Center
Practice address
9203 W Overland Rd
Boise, ID 83709-2502
Phone
(208) 375-1012
NPI assigned
Jun 5, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 5, 2008

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

Authorized official

Name
Dr. Guy Matthew Hanson, DDS
Title
President
Phone
(208) 375-1012

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X D1850 ID Primary

Addresses

Primary practice location

9203 W Overland Rd
Boise, ID 83709-2502

Mailing address

9203 W Overland Rd
Boise, ID 83709-2502
Phone (208) 375-1012

Other names 1

  • Idaho Dental Wellness Center Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Guy M Hanson DDS PA2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1212624000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1212624000000",
    "number": "1255590105",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9203 W OVERLAND RD",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837092502",
            "telephone_number": "208-375-1012"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9203 W OVERLAND RD",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837092502",
            "telephone_number": "208-375-1012"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GUY M HANSON DDS PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-06-05",
        "last_updated": "2008-06-05",
        "status": "A",
        "authorized_official_last_name": "HANSON",
        "authorized_official_first_name": "GUY",
        "authorized_official_middle_name": "MATTHEW",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "208-375-1012",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "ID",
            "license": "D1850",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Idaho Dental Wellness Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Boise, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2008; 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.