Hani Abdel Hamid Hamdan, DDS, MS

Primary specialty

DentistTaxonomy code 122300000X

License

D11929 Issued in MN

Practice address

19685 Pilot Knob Rd Ste 200
Farmington, MN 55024-7238

Phone

(651) 333-9336

Fax

(651) 344-8945

NPI assigned

Apr 24, 2006

Last updated

Oct 5, 2020By the provider in NPPES

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

Enrolled in MN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

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

{
    "created_epoch": "1145836800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1601856000000",
    "number": "1932165529",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19685 PILOT KNOB RD STE 200",
            "city": "FARMINGTON",
            "state": "MN",
            "postal_code": "550247238",
            "telephone_number": "651-333-9336",
            "fax_number": "651-344-8945"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19685 PILOT KNOB RD STE 200",
            "city": "FARMINGTON",
            "state": "MN",
            "postal_code": "550247238",
            "telephone_number": "651-333-9336",
            "fax_number": "651-344-8945"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "14344 Burnhaven Dr",
            "address_purpose": "LOCATION",
            "city": "Burnsville",
            "state": "MN",
            "postal_code": "55306",
            "country_code": "US",
            "telephone_number": "952-435-8525",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HAMDAN",
        "first_name": "HANI",
        "middle_name": "ABDEL HAMID",
        "name_prefix": "Dr.",
        "credential": "DDS, MS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-24",
        "last_updated": "2020-10-05",
        "certification_date": "2020-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MN",
            "license": "D11929",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2020; 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.