Robert Carl Hansen Jr., DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

6036 Issued in IA

Practice address

1115 South St
Waterloo, IA 50702-2330

Phone

(319) 233-2759

Fax

(319) 233-4852

NPI assigned

Oct 29, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in IA

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

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1162080000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1861578189",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1115 SOUTH ST",
            "city": "WATERLOO",
            "state": "IA",
            "postal_code": "507022330",
            "telephone_number": "319-233-2759",
            "fax_number": "319-233-4852"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1115 SOUTH ST",
            "city": "WATERLOO",
            "state": "IA",
            "postal_code": "507022330",
            "telephone_number": "319-233-2759",
            "fax_number": "319-233-4852"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HANSEN",
        "first_name": "ROBERT",
        "middle_name": "CARL",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-29",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IA",
            "license": "6036",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0098178",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Allison Marie Hancock, PTA, ATC, LAT
• Kirre Hannan, PHARMD
• Andrea Leigh Hansen, PA
• Danielle Hansen, LMSW
• Erin Colleen Hansen, DOCTOR OF PHARMACY
• Scott Ryan Hansen, DDS
• Tricia R Hansen, RN
• Teresa Hanson, DNP, PMHNP
• Alexandra Ann Harden, TLMHC
• James Howard Harding, PH.D

• General Practice Dentistry in Waterloo, IA
• Providers in Waterloo, IA by specialty
• General Practice Dentistry in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.