Active NPI
Gregory Borg Hanson, DDS
- Dentist
- Bloomington, MN
National Provider Identifier
1871560078
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 1661240
- Practice address
- 5270 W 84 St
Bloomington, MN 55437 - Phone
- (952) 835-0666
- Fax
- (952) 835-1391
- NPI assigned
- Mar 7, 2006
- Sex
- Male
- Sole proprietor
- No
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 | 1661240 | MN | Primary |
Addresses
Primary practice location
5270 W 84 St
Bloomington, MN 55437
Mailing address
5270 W 84 St
Bloomington, MN 55437
Phone (952) 835-0666
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 303586 | Other | MN | MEDICAL ASSITANCE |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1661240 | MN | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1141689600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1457481600000",
"number": "1871560078",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5270 W 84 ST",
"city": "BLOOMINGTON",
"state": "MN",
"postal_code": "55437",
"telephone_number": "952-835-0666",
"fax_number": "952-835-1391"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5270 W 84 ST",
"city": "BLOOMINGTON",
"state": "MN",
"postal_code": "55437",
"telephone_number": "952-835-0666",
"fax_number": "952-835-1391"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HANSON",
"first_name": "GREGORY",
"middle_name": "BORG",
"name_prefix": "Mr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-03-07",
"last_updated": "2016-03-09",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "MN",
"license": "1661240",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICAL ASSITANCE",
"identifier": "303586",
"state": "MN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Bloomington, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 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.