Hancock Dental

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

HANCOCK DENTAL

Doing business as

Hancock Dental

Practice address

485 W Chubbuck Rd Ste a
Chubbuck, ID 83202-2308

Phone

(208) 234-1006

Fax

(208) 234-8990

NPI assigned

Jun 8, 2023

Organization subpart

Yes

Parent organization

HANCOCK DENTALAs reported in NPPES

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

Authorized official

Name

Dr. Tad E Hancock, DDSNPI 1528139201

Title

Owner

Phone

(208) 234-1006

Specialties & licenses 1

Addresses

Other names 1

• Hancock Dental Doing business as

Part of

Hancock Dental

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Tad E Hancock, DDS

  • General Practice Dentistry
  • Chubbuck, ID
  • NPI 1528139201
  NPD Authorized official

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

{
    "created_epoch": "1686182400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1686182400000",
    "number": "1609560937",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "485 W CHUBBUCK RD STE A",
            "city": "CHUBBUCK",
            "state": "ID",
            "postal_code": "832022308",
            "telephone_number": "208-234-1006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "485 W CHUBBUCK RD STE A",
            "city": "CHUBBUCK",
            "state": "ID",
            "postal_code": "832022308",
            "telephone_number": "208-234-1006",
            "fax_number": "208-234-8990"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HANCOCK DENTAL",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "HANCOCK DENTAL",
        "enumeration_date": "2023-06-08",
        "last_updated": "2023-06-08",
        "certification_date": "2023-06-08",
        "status": "A",
        "authorized_official_last_name": "HANCOCK",
        "authorized_official_first_name": "TAD",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "208-234-1006",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Hancock Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Angela Jade Griffin
• Brookelle Smith Gunn, PA
• Steven Haack, PHARMD
• Michael John Haderlie, MD
• Jeremy W Hale, D.C.
• Tad E Hancock, DDS
• Hannah'S Place LLC
• Charlie N Hansen, LPC
• Lizarose Y. T. Hansen, CERTIFIED FAMILY HOM
• Paul Hansmann, PHD

• Dental Clinic/Center in Chubbuck, ID
• Providers in Chubbuck, ID by specialty
• Dental Clinic/Center in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2023; 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.