Active NPI
Nathan Hansen, DDS
- Dentist
- Placerville, CA
National Provider Identifier
1376800391
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 62370
- Practice address
- 5168 Honpie Rd
Placerville, CA 95667-8682 - Phone
- (530) 387-4232
- NPI assigned
- Apr 15, 2012
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 62370 | CA | Primary |
Addresses
Primary practice location
5168 Honpie Rd
Placerville, CA 95667-8682
Mailing address
1860 Howe Ave Ste 440
Sacramento, CA 95825-1098
Phone (916) 569-8484
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20150722003830 | CA | Order and Referring Only - Dentist | 2264745082 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1334448000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1692576000000",
"number": "1376800391",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1860 HOWE AVE STE 440",
"city": "SACRAMENTO",
"state": "CA",
"postal_code": "958251098",
"telephone_number": "916-569-8484"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5168 HONPIE RD",
"city": "PLACERVILLE",
"state": "CA",
"postal_code": "956678682",
"telephone_number": "530-387-4232"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HANSEN",
"first_name": "NATHAN",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2012-04-15",
"last_updated": "2023-08-21",
"certification_date": "2023-07-06",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "CA",
"license": "62370",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Placerville, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.