Individual provider Active NPI

Kristen Hann

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Brentwood, CA
National Provider Identifier
1518408848
Registry record updated Mar 20, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
License
62293 Issued in CA
Practice address
100 Cortona Way Ste 250
Brentwood, CA 94513-7160
Phone
(925) 240-2070
Fax
(925) 240-2073
NPI assigned
Mar 20, 2017
Last updated
Mar 20, 2017By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 20, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X 62293 CA Primary

Addresses

Primary practice location

100 Cortona Way Ste 250
Brentwood, CA 94513-7160

Mailing address

100 Cortona Way Ste 250
Brentwood, CA 94513-7160
Phone (925) 240-2070

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
62293CAMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1489968000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1489968000000",
    "number": "1518408848",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 CORTONA WAY STE 250",
            "city": "BRENTWOOD",
            "state": "CA",
            "postal_code": "945137160",
            "telephone_number": "925-240-2070",
            "fax_number": "925-240-2073"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 CORTONA WAY STE 250",
            "city": "BRENTWOOD",
            "state": "CA",
            "postal_code": "945137160",
            "telephone_number": "925-240-2070",
            "fax_number": "925-240-2073"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HANN",
        "first_name": "KRISTEN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-03-20",
        "last_updated": "2017-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "CA",
            "license": "62293",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brentwood, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.