Jeffrey Val Hansen, D.D.S.

Individual provider Active NPI General Practice Dentistry · Syracuse, UT

NPI 1275891731 · NPPES record last updated May 2, 2012

Key facts

NPI
1275891731
Entity type
Individual (NPI type 1)
Primary specialty
General Practice Dentistry 1223G0001X
License
370824-9922 (UT)
Practice address
1747 Heritage LN Ste B203
Syracuse, UT 84075-8532
Phone
(801) 525-1725
Fax
(801) 525-0988
NPI assigned
May 2, 2012
Sex
Male
Sole proprietor
No

Organizations & group practices 1

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.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
370824-9922UTMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Dr Hansens Family Dentistry LLC General Practice Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 370824-9922 UT Yes

Addresses

Primary practice location

1747 Heritage LN Ste B203
Syracuse, UT 84075-8532

Mailing address

1747 Heritage LN Ste B203
Syracuse, UT 84075-8532
Phone (801) 525-1725

Other providers in Syracuse, UT

All providers in Syracuse, UT · General Practice Dentistry in Utah

Sources for this page

Verify at the official NPI Registry.