Individual provider Active NPI

Brooke Nicole Hamann, D.D.S.

  • Dentist
  • Perham, MN
National Provider Identifier
1710206016
Registry record updated Jun 3, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
D12790 Issued in MN
Practice address
200 1St Ave S
Perham, MN 56573-1495
Phone
(218) 346-4775
Fax
(218) 346-5775
NPI assigned
May 26, 2010
Last updated
Jun 3, 2010By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 3, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X D12790 MN Primary

Addresses

Primary practice location

200 1St Ave S
Perham, MN 56573-1495

Mailing address

200 1St Ave S
Perham, MN 56573-1495
Phone (218) 346-4775

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
I20160503002660 MN Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 1153620752

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
D12790MNMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Michael L Hamann DDS PA 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, 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": "1274832000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1275523200000",
    "number": "1710206016",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 1ST AVE S",
            "city": "PERHAM",
            "state": "MN",
            "postal_code": "565731495",
            "telephone_number": "218-346-4775",
            "fax_number": "218-346-5775"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 1ST AVE S",
            "city": "PERHAM",
            "state": "MN",
            "postal_code": "565731495",
            "telephone_number": "218-346-4775",
            "fax_number": "218-346-5775"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAMANN",
        "first_name": "BROOKE",
        "middle_name": "NICOLE",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-05-26",
        "last_updated": "2010-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MN",
            "license": "D12790",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Perham, MN

Sources for this page

Verify at the official NPI Registry.