Individual provider Active NPI

Bruce H Hansen, DDS

  • General Practice Dentistry
  • Arden Hills, MN
National Provider Identifier
1588775670
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
10461 Issued in MN
Practice address
3930 Northwoods Dr
Arden Hills, MN 55112
Phone
(651) 490-6775
Fax
(651) 490-6754
NPI assigned
Aug 31, 2006
Last updated
Jul 8, 2007By the provider in NPPES
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 10461 MN Primary

Addresses

Primary practice location

3930 Northwoods Dr
Arden Hills, MN 55112

Mailing address

PO Box 1309
Mail Code 21113a
Minneapolis, MN 55440-1309
Phone (952) 883-5151

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20080716000855 MN Practitioner - Oral Surgery 6204909732 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Group Health, Inc. General Practice CurrentSince May 31, 2011 Accepting new patients
Group Health, Inc. Current Accepting new patients
Group Health, Inc. General Practice CurrentSince May 31, 2011 Accepting new patients

Locations

3930 Northwoods Dr
Saint Paul, MN 55112
Phone (651) 490-6775

Organizations & group practices 3

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": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1588775670",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1309",
            "address_2": "MAIL CODE 21113A",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554401309",
            "telephone_number": "952-883-5151",
            "fax_number": "952-883-5160"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3930 NORTHWOODS DR",
            "city": "ARDEN HILLS",
            "state": "MN",
            "postal_code": "55112",
            "telephone_number": "651-490-6775",
            "fax_number": "651-490-6754"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HANSEN",
        "first_name": "BRUCE",
        "middle_name": "H",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-31",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MN",
            "license": "10461",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Arden Hills, MN

Sources for this page

Verify at the official NPI Registry.