Nathan Lee Hanson, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

D14585 Issued in MN

Practice address

403 1St Ave E
Shakopee, MN 55379-1439

Phone

(952) 445-5556

NPI assigned

Jun 16, 2021

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• TPC Enterprises

  dba RiverRock Dental

  • Dental Clinic/Center
  • Shakopee, MN
  • NPI 1770137655
  NPD

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

{
    "created_epoch": "1623801600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623801600000",
    "number": "1922676782",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "616 OAK ST W",
            "city": "STILLWATER",
            "state": "MN",
            "postal_code": "550825624",
            "telephone_number": "651-329-5703"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "403 1ST AVE E",
            "city": "SHAKOPEE",
            "state": "MN",
            "postal_code": "553791439",
            "telephone_number": "952-445-5556"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HANSON",
        "first_name": "NATHAN",
        "middle_name": "LEE",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-06-16",
        "last_updated": "2021-06-16",
        "certification_date": "2021-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MN",
            "license": "D14585",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mark Halbkat
• Jessica Haller-Chew, OT
• Batsheva Halpert, LICSW
• Michelle Lynn Hammerschmidt, L.AC.
• Mark Hanson
• John Leslie Harder, DC
• Eric Harl, PA-C
• Kim Harmon, MSW, LICSW
• Cynthia Harvath, MD
• Tami Jo Haugen, MS, PT

• General Practice Dentistry in Shakopee, MN
• Providers in Shakopee, MN by specialty
• General Practice Dentistry in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2021; 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.