Active NPI
Michael Hanna
- Dentist
- Walnut, CA
National Provider Identifier
1649714247
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 101090
- Practice address
- 21230 Stockton Pass Rd
Walnut, CA 91789-5109 - Phone
- (909) 348-2074
- NPI assigned
- Dec 15, 2016
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 101090 | CA | Primary |
Addresses
Primary practice location
21230 Stockton Pass Rd
Walnut, CA 91789-5109
Mailing address
21230 Stockton Pass Rd
Walnut, CA 91789-5109
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Michael Hanna Dental Corp | Dentist | Past | Accepting new patients |
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": "1481760000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1481760000000",
"number": "1649714247",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "21230 STOCKTON PASS RD",
"city": "WALNUT",
"state": "CA",
"postal_code": "917895109"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "21230 STOCKTON PASS RD",
"city": "WALNUT",
"state": "CA",
"postal_code": "917895109",
"telephone_number": "909-348-2074"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HANNA",
"first_name": "MICHAEL",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2016-12-15",
"last_updated": "2016-12-15",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "CA",
"license": "101090",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Walnut, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.