NPIMap

Paul S Hansen, D.M.D.

Individual provider Active NPI General Practice Dentistry · Estacada, OR

NPI 1699717868 · NPPES record last updated Oct 10, 2025

Key facts

NPI
1699717868
Entity type
Individual (NPI type 1)
Primary specialty
General Practice Dentistry 1223G0001X
License
D6973 (OR)
Practice address
630 N Broadway St
PO Box 929
Estacada, OR 97023-0929
Phone
(503) 630-4218
NPI assigned
Jun 12, 2006
Sex
Male
Sole proprietor
Yes

Organizations & group practices 2

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.

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
D6973ORMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Estacada Family Dental, LLC General Practice Current
since Oct 12, 2025		 Accepting new patients
Mt. Hood Dental Clinic Past Accepting new patients

Locations

630 N Broadway St
Estacada, OR 97023
Phone (503) 630-4218

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X D6973 OR Yes

Addresses

Primary practice location

630 N Broadway St
PO Box 929
Estacada, OR 97023-0929

Mailing address

PO Box 929
Estacada, OR 97023-0929
Phone (503) 630-4218

Other providers in Estacada, OR

All providers in Estacada, OR · General Practice Dentistry in Oregon

Sources for this page

Verify at the official NPI Registry.