DR. HEIDI J HANSEN (NPI# 1063655967) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1063655967 |
| Entity Type | Individual |
| Full Name | DR. HEIDI J HANSEN |
| Credential | D.M.D. |
| Practice Address |
4805 Ne Glisan St Ste 11n Portland OR 97213-2933 |
| Mailing Address |
Po Box 3158 Portland OR 97208-3158 |
| Practice Telephone | 5032151676 |
| Mailing Telephone | 5032156494 |
| Enumeration Date | 2009-04-08 |
| Last Update Date | 2020-11-02 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 122300000X | Dentist | D11216 | OR | Dental Providers |
| N | 122300000X | Dentist | 055295 | NY | Dental Providers |
| Y | 125Q00000X | Oral Medicinist | D11216 | OR | Dental Providers |
| N | 125Q00000X | Oral Medicinist | 055295 | NY | Dental Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 525 E 68th St, F-2132, New York, NY 100654870 | 2127465115 | 2127468400 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669096806 | Heidi Jane Hansen | Physical Medicine & Rehabilitation | 1 Kennedy Dr # U3-4, South Burlington, VT 05403-7152 | 2020-06-03 |
| 1023523230 | Heidi Ann Hansen | Counselor | 505 S 12th Ave W Ste 1, Virginia, MN 55792-2001 | 2017-12-11 |
| 1053790667 | Heidi Hansen | Speech-Language Pathologist | 9 Summit Avenue, Suite B, Asheville, NC 28803-1938 | 2015-05-28 |
| 1548415912 | Heidi Lea Hansen | Speech-Language Pathologist | 47 Priscilla Ln, Port Chester, NY 10573-2316 | 2008-11-26 |
| 1225249238 | Heidi Hansen | Massage Therapist | 180 N 100 E, Suite H, Richfield, UT 84701-2132 | 2007-05-24 |
| 1992771984 | Heidi Hansen | Chiropractor | 710 W Lawrence Ave, Charlotte, MI 48813-1326 | 2006-02-28 |
| 1669978045 | Heidi Jean Hansen | Counselor | 320 N Eisenhower Ave, Mason City, IA 50401-1521 | 2018-04-03 |
| 1598134660 | Heidi Jo Hansen | Speech-Language Pathologist | 909 S 76th St, Omaha, NE 68114-4519 | 2015-09-18 |
| 1184052458 | Heidi Hansen | Surgery | 7440 S 91st St, Lincoln, NE 68526-9797 | 2013-10-24 |
| 1629414578 | Heidi Ann Hansen | Registered Nurse | 366 E George St, Ivanhoe, MN 56142-9711 | 2013-05-20 |
| Street Address |
4805 NE GLISAN ST STE 11N |
| City | PORTLAND |
| State | OR |
| Zip Code | 97213-2933 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801010004 | Providence Health & Services Oregon | Internal Medicine | 4805 Ne Glisan St Ste 11n, Portland, OR 97213-2933 | 2007-04-12 |
| 1205479441 | Angie M Kang | Pharmacist | 4805 Ne Glisan St Ste 11n, Portland, OR 97213-2933 | 2019-10-21 |
| 1023576659 | Rhezarie Mae A Agtarap | Registered Nurse | 4805 Ne Glisan St Ste 11n, Portland, OR 97213-2933 | 2019-03-01 |
| 1154809903 | Molly Christine Davis | Nurse Practitioner | 4805 Ne Glisan St Ste 11n, Portland, OR 97213-2933 | 2018-08-03 |
| 1649716267 | Garrett Wilson | Physician Assistant | 4805 Ne Glisan St Ste 11n, Portland, OR 97213-2933 | 2017-01-07 |
| 1336568369 | Hasnain A Hasham | Radiology | 4805 Ne Glisan St Ste 11n, Portland, OR 97213-2933 | 2014-04-07 |
| 1497098941 | Evelyn M Brosnan | Internal Medicine | 4805 Ne Glisan St Ste 11n, Portland, OR 97213-2933 | 2013-04-03 |
| 1316197692 | Providence Health & Services Oregon | Clinic/Center | 4805 Ne Glisan St Ste 11n, Portland, OR 97213-2933 | 2008-09-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831715176 | Darnell Jackie Strong | Social Worker | 435 Ne 78th Ave 'strong Counseling Services', Portland, OR 97213 | 2020-06-23 |
| 1336775907 | Redpoint Physical Therapy and Performance LLC | Physical Therapist | 4200 Ne Flanders St Unit B, Portland, OR 97213 | 2020-03-16 |
| 1801431218 | Denise Dorgan-miller | Occupational Therapy Assistant | Providence Elder Place, 4400 Ne Halsey Suite 200, Portland, OR 97213 | 2019-11-08 |
| 1619435617 | Aspiration of Character Counseling Services, LLC | Counselor | 4424 Ne Glisan St, The Li Wellness Building, Second Floor, Portland, OR 97213 | 2019-03-08 |
| 1578049631 | Credena Health LLC | Pharmacy | 4805 Ne Glisan St Ste 11n321, Portland, OR 97213 | 2018-07-12 |
| 1023507795 | Karissa Lynn Schwartz | Speech-Language Pathologist | Providence Portland Medical Center, 4805 Ne Glisan St, Portland, OR 97213 | 2018-05-08 |
| 1861944506 | James Livingston Taylor | Chiropractor | 5212 Ne Sacremento St., Portland, OR 97213 | 2016-10-28 |
| 1962958520 | Caitlin Turner | Massage Therapist | 4317 Ne Tillamook St., Portland, OR 97213 | 2016-09-01 |
| 1326407008 | Julianna Vermeys | Counselor | 4605 Ne Fremont St., 209a, Portland, OR 97213 | 2016-02-23 |
| 1881059822 | Thomas Michael Barrett | Counselor | 5228 Ne Hoyt St. Bldg. B, Portland, OR 97213 | 2015-12-17 |
| Find all providers in zip 97213 | ||||
| Taxonomy Code | 125Q00000X |
| Grouping | Dental Providers |
| Classification | Oral Medicinist |
| A dentist with advanced training specializing in the recognition and treatment of oral conditions resulting from the interrelationship between oral disease and systemic health. The Oral Medicinist manages clinical and non-surgical treatment of non-dental pathologies affecting the oral and maxillofacial region, such as cancer, organ transplants, and acute and chronic pain. Activities include provision of interdisciplinary patient care in collaboration with medical specialists and other dentists in hospitals and outpatient medical clinics in the management of patients with complex medical conditions requiring multidisciplinary healthcare intervention. |
| Notes: Source: National Uniform Claim Committee [1/1/2015: new] Additional Resources: American Academy of Oral Medicine |
Please comment or provide details below to improve the information on DR. HEIDI J HANSEN.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.