Individual provider Active NPI

Joseph Michael Hanrahan, D.D.S.

  • General Practice Dentistry
  • Bothell, WA
National Provider Identifier
1811071079
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DE00006366 Issued in WA
Practice address
18222 104TH Ave NE
Suite 106
Bothell, WA 98011-3491
Phone
(425) 481-7790
NPI assigned
Oct 24, 2006
Sex
Male
Sole proprietor
Yes

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 DE00006366 WA Primary

Addresses

Primary practice location

18222 104TH Ave NE
Suite 106
Bothell, WA 98011-3491

Mailing address

18222 104TH Ave NE
Suite 106
Bothell, WA 98011-3491
Phone (425) 481-7790

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
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
I20160519001051 WA Order and Referring Only - DentistPractitioner - Dentist 3072802750

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1161648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1811071079",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18222 104TH AVE NE",
            "address_2": "SUITE 106",
            "city": "BOTHELL",
            "state": "WA",
            "postal_code": "980113491",
            "telephone_number": "425-481-7790"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18222 104TH AVE NE",
            "address_2": "SUITE 106",
            "city": "BOTHELL",
            "state": "WA",
            "postal_code": "980113491",
            "telephone_number": "425-481-7790"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HANRAHAN",
        "first_name": "JOSEPH",
        "middle_name": "MICHAEL",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-24",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WA",
            "license": "DE00006366",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bothell, WA

Sources for this page

Verify at the official NPI Registry.