Individual provider Active NPI

Alicia Marie Berger Hansen, D.D.S.

  • General Practice Dentistry
  • Sioux Falls, SD
National Provider Identifier
1396839874
Registry record updated Aug 16, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
D0933 Issued in SD
Practice address
5201 S Western Ave
Sioux Falls, SD 57108-5040
Phone
(605) 339-2200
Fax
(605) 334-5530
NPI assigned
Oct 2, 2006
Last updated
Aug 16, 2010By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 16, 2010

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X D12260 MN
General Practice Dentistry 1223G0001X D0933 SD Primary

Addresses

Primary practice location

5201 S Western Ave
Sioux Falls, SD 57108-5040

Mailing address

5201 S Western Ave
Sioux Falls, SD 57108-5040

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SD
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
I20150317002819 SD Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 1254658974

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
D12260MNMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
South Western Dental General Practice Past Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1159747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1281916800000",
    "number": "1396839874",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5201 S WESTERN AVE",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571085040",
            "fax_number": "605-334-5530"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5201 S WESTERN AVE",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571085040",
            "telephone_number": "605-339-2200",
            "fax_number": "605-334-5530"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HANSEN",
        "first_name": "ALICIA",
        "middle_name": "MARIE BERGER",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-02",
        "last_updated": "2010-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MN",
            "license": "D12260",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "SD",
            "license": "D0933",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sioux Falls, SD

Sources for this page

Verify at the official NPI Registry.