Individual provider Active NPI

Peter John Hanna Jr., DDS

  • General Practice Dentistry
  • Alexandria, VA
National Provider Identifier
1487725438
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
4340 Issued in VA
Practice address
516 Oronoco St
Alexandria, VA 22314
Phone
(703) 549-1960
Fax
(703) 549-4919
NPI assigned
Nov 13, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 4340 VA Primary

Addresses

Primary practice location

516 Oronoco St
Alexandria, VA 22314

Mailing address

516 Oronoco St
Alexandria, VA 22314
Phone (703) 549-1960

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
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
I20151222000276 VA Order and Referring Only - DentistPractitioner - Dentist 6608177324

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4340VAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Stella Kim DDS PLLC PastSince Jul 24, 2022 Accepting new patients

Interoperability endpoints

  • Direct secure messaging: peter.hanna.1@20427.direct.athenahealth.com

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.

NPI Registry JSON

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

{
    "created_epoch": "1163376000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1487725438",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "516 ORONOCO ST",
            "city": "ALEXANDRIA",
            "state": "VA",
            "postal_code": "22314",
            "telephone_number": "703-549-1960",
            "fax_number": "703-549-4919"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "516 ORONOCO ST",
            "city": "ALEXANDRIA",
            "state": "VA",
            "postal_code": "22314",
            "telephone_number": "703-549-1960",
            "fax_number": "703-549-4919"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HANNA",
        "first_name": "PETER",
        "middle_name": "JOHN",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-13",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "VA",
            "license": "4340",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Alexandria, VA

Sources for this page

Verify at the official NPI Registry.