| Hansen Family Dental Pllc | |
|
6615 W Argent Rd Pasco WA 99301-1905 | |
| (509) 547-9951 | |
| (509) 547-3008 |
| Full Name | Hansen Family Dental Pllc |
|---|---|
| Speciality | Dentist |
| Location | 6615 W Argent Rd, Pasco, Washington |
| Authorized Official Name and Position | James R Hansen (OWNER) |
| Authorized Official Contact | 5095479951 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Hansen Family Dental Pllc 6615 W Argent Rd Pasco WA 99301-1905 Ph: (509) 547-9951 | Hansen Family Dental Pllc 6615 W Argent Rd Pasco WA 99301-1905 Ph: (509) 547-9951 |
| NPI Number | 1114045937 |
|---|---|
| Provider Enumeration Date | 03/27/2007 |
| Last Update Date | 05/14/2021 |
| Medicare PECOS PAC ID | 3476962903 |
|---|---|
| Medicare Enrollment ID | O20210512002602 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1114045937 | NPI | - | NPPES |
| 5052253 | Medicaid | WA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 10263 (Washington) | Primary |
| Provider Name | James R Hansen |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1184856999 PECOS PAC ID: 7113341983 Enrollment ID: I20210514001924 |
| Provider Name | Dallas S Mcmanamon |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1902470347 PECOS PAC ID: 5193125326 Enrollment ID: I20210609003629 |
| Provider Name | Nathan E Bushman |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1821449273 PECOS PAC ID: 4385031822 Enrollment ID: I20220502000257 |
| Provider Name | Kyle Rowley |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1508351651 PECOS PAC ID: 7911361738 Enrollment ID: I20230913000648 |
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