Ishmael Hasan, D.D.S

Primary specialty

EndodonticsTaxonomy code 1223E0200X

License

DE60856783 Issued in WA

Practice address

907 Frontier Cir E Ste 100
Lake Stevens, WA 98258-2423

Phone

(425) 697-9219

NPI assigned

Feb 27, 2013

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1361923200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716422400000",
    "number": "1902146954",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 58312",
            "city": "TUKWILA",
            "state": "WA",
            "postal_code": "981381312"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "907 FRONTIER CIR E STE 100",
            "city": "LAKE STEVENS",
            "state": "WA",
            "postal_code": "982582423",
            "telephone_number": "425-697-9219"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1338 E Ridge Rd",
            "address_purpose": "LOCATION",
            "city": "Rochester",
            "state": "NY",
            "postal_code": "146212018",
            "country_code": "US",
            "telephone_number": "585-544-2003",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HASAN",
        "first_name": "ISHMAEL",
        "credential": "D.D.S",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-02-27",
        "last_updated": "2024-05-23",
        "certification_date": "2024-05-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "PA",
            "license": "DS044581",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "50 058325",
            "primary": false
        },
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "WA",
            "license": "DE60856783",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brian Daniel Gross, LMP
• Kalli A Gunnyon, LMT
• John Hammack, MA
• Peter Hanson, D.C.
• Lori Hartelius, M.S., LMHC
• Timothy Hassler, LMP
• Marylou Hatcher, MD
• Karla Callahan Hawley, MT-BC
• Healthy Smiles Northwest
• Lisette Christine Heilman, RPH

• Endodontics in Lake Stevens, WA
• Providers in Lake Stevens, WA by specialty
• Endodontics in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.