Charles Hannon, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

D13658 Issued in MN

Practice address

1421 Wayzata Blvd Ste 300
Wayzata, MN 55391-4109

Phone

(951) 473-1521

NPI assigned

May 29, 2016

Last updated

Apr 21, 2022By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MN

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Hannon Dental, P.L.L.C.

  dba McGill Family Dentistry

  • Dental Clinic/Center
  • Wayzata, MN
  • NPI 1659020824
  NPD Authorized official
• Theresa M. Snell

  dba Silver Lake Dental

  • Dental Clinic/Center
  • New Brighton, MN
  • NPI 1033710025
  NPD (past)

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

{
    "created_epoch": "1464480000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1650499200000",
    "number": "1487002655",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1421 WAYZATA BLVD STE 300",
            "city": "WAYZATA",
            "state": "MN",
            "postal_code": "553914109",
            "telephone_number": "952-473-1521"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1421 WAYZATA BLVD STE 300",
            "city": "WAYZATA",
            "state": "MN",
            "postal_code": "553914109",
            "telephone_number": "951-473-1521"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HANNON",
        "first_name": "CHARLES",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-05-29",
        "last_updated": "2022-04-21",
        "certification_date": "2022-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MN",
            "license": "D13658",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Hakim Medical Enterprises, P.a.
• Hammer Residences, Inc (Hammer)
• Hammer Residences, Inc.
• Hammer Residences, Inc.
• Hannon Dental, P.L.L.C. (McGill Family Dentistry)
• Jodi S Haroldson, PT
• Katherine Jane Haskin, L.M.F.T.
• Pamela Hasselbring
• Timothy P Haupert, O.D.
• Healing Roots Counseling

• Dentist in Wayzata, MN
• Providers in Wayzata, MN by specialty
• Dentist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2022; 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.

Verify at the official NPI Registry.