Individual provider Active NPI

George Joseph Hanna, DDS

  • Dentist
  • Pasadena, CA
National Provider Identifier
1366636128
Registry record updated Feb 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
56218 Issued in CA
Practice address
350 S Lake Ave Ste 250
Pasadena, CA 91101-3532
Phone
(626) 449-2239
NPI assigned
Sep 4, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 20, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 56218 CA Primary

Addresses

Primary practice location

350 S Lake Ave Ste 250
Pasadena, CA 91101-3532

Mailing address

4313 Oakwood Ave
La Canada, CA 91011-3412
Phone (714) 932-6024

Other practice location 1

1655 Hillhurst Ave Ste 101
Los Angeles, CA 90027-5577
Phone (323) 660-8088

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150813010000 CA Order and Referring Only - DentistPractitioner - Dentist 5092020545

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
56218CAMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1188864000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708387200000",
    "number": "1366636128",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4313 OAKWOOD AVE",
            "city": "LA CANADA",
            "state": "CA",
            "postal_code": "910113412",
            "telephone_number": "714-932-6024"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "350 S LAKE AVE STE 250",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911013532",
            "telephone_number": "626-449-2239"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1655 Hillhurst Ave Ste 101",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "900275577",
            "country_code": "US",
            "telephone_number": "323-660-8088",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HANNA",
        "first_name": "GEORGE",
        "middle_name": "JOSEPH",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-09-04",
        "last_updated": "2024-02-20",
        "certification_date": "2024-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "56218",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pasadena, CA

Sources for this page

Verify at the official NPI Registry.