Individual provider Active NPI

Lisa E Hansen, D.D.S.

  • General Practice Dentistry
  • Simi Valley, CA
National Provider Identifier
1902026503
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
47371 Issued in CA
Practice address
1987 Royal Ave
Suite # 4
Simi Valley, CA 93065-4655
Phone
(805) 527-3306
Fax
(805) 578-6529
NPI assigned
Apr 26, 2007
Sex
Female
Sole proprietor
No

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 47371 CA Primary

Addresses

Primary practice location

1987 Royal Ave
Suite # 4
Simi Valley, CA 93065-4655

Mailing address

1987 Royal Ave
Suite # 4
Simi Valley, CA 93065-4655
Phone (805) 527-3306

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20160301002437 CA Order and Referring Only - DentistPractitioner - Dentist 9537464482

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
J.Y. Tokuyama, D.D.S. and L.E. Hansen, D.D.S., a Professional Corporat General Practice 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1177545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1902026503",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1987 ROYAL AVE",
            "address_2": "SUITE # 4",
            "city": "SIMI VALLEY",
            "state": "CA",
            "postal_code": "930654655",
            "telephone_number": "805-527-3306",
            "fax_number": "805-578-6529"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1987 ROYAL AVE",
            "address_2": "SUITE # 4",
            "city": "SIMI VALLEY",
            "state": "CA",
            "postal_code": "930654655",
            "telephone_number": "805-527-3306",
            "fax_number": "805-578-6529"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HANSEN",
        "first_name": "LISA",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-26",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "47371",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Simi Valley, CA

Sources for this page

Verify at the official NPI Registry.