Healthcare Provider Details

I. General information

NPI: 1760483580
Provider Name (Legal Business Name): CLAUDIA ERIN HANNAH DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CLAUDIA ERIN OSTTEEN DDS

II. Dates (important events)

Enumeration Date: 08/02/2005
Last Update Date: 04/15/2026
Certification Date: 04/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11 BASSWOOD RD
PARAJE NM
87007-1004
US

IV. Provider business mailing address

PO BOX 1407
LAGUNA NM
87026-1407
US

V. Phone/Fax

Practice location:
  • Phone: 505-552-6644
  • Fax: 505-552-1191
Mailing address:
  • Phone: 505-552-6644
  • Fax: 505-552-1191

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number2023014105
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: