Amelia Hanney, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

110529 Issued in CA

Practice address

801 River Dr
Fort Bragg, CA 95437-5404

Phone

(707) 964-8080

NPI assigned

Aug 10, 2024

Sex

Female

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not 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 and National Provider Directory roles.

• Brandon Lebeck Dental Corp

  • Dental Clinic/Center
  • Fort Bragg, CA
  • NPI 1174330963
  NPD

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

{
    "created_epoch": "1723248000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723248000000",
    "number": "1548091663",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1197 PHEASANT HILL CT",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951205823",
            "telephone_number": "408-826-7356"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 RIVER DR",
            "city": "FORT BRAGG",
            "state": "CA",
            "postal_code": "954375404",
            "telephone_number": "707-964-8080"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HANNEY",
        "first_name": "AMELIA",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-08-10",
        "last_updated": "2024-08-10",
        "certification_date": "2024-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "110529",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Guy Wayne Grenny, PH.D.
• Eric I Gutnick, MD
• Hackley Physical Therapy, Inc.
• Shawn Rueze Hackley, P.T.
• Gretchen Hahn, LMFT
• Happy Rides Inc.
• Happy Rides LLC
• Crystal Marie Harris, LCSW
• Diane I. Harris, MD
• Elizabeth Hayes Harvey

• General Practice Dentistry in Fort Bragg, CA
• Providers in Fort Bragg, CA by specialty
• General Practice Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2024; 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.