MEDICARE: DR. NATHANIEL SCOTT HANSEN DDS, MS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223X0400X	Orthodontics and Dentofacial Orthopedics Dentistry	40193	TX

General Provider Information

NPI Number	:	1275177974
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. NATHANIEL SCOTT HANSEN DDS, MS

Provider Business Mailing Address
First Line	:	6034 CAMINO PINON PL
Second Line	:
City	:	EL PASO
State	:	TX
Zip	:	79932
Country	:	US
Telephone Number	:	316-573-6686
Fax Number	:

Provider Business Practice Location Address
First Line	:	7340 CIMARRON MARKET AVE
Second Line	:	BUILDING B
City	:	EL PASO
State	:	TX
Zip	:	79912
Country	:	US
Telephone Number	:	915-201-0881
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/05/2019
Last Update Date	:	05/12/2025

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