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NPI Code Detail

MEDICARE: DR. GERALD V. HANSEN DDS

MEDICARE: DR. GERALD V. HANSEN DDS
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
11223G0001XGeneral Practice Dentistry2490NV

General Provider Information

NPI Number : 1467455253
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. GERALD V. HANSEN DDS
Provider Business Mailing Address
First Line : 740 DEL MONTE LN#1
Second Line :
City : RENO
State : NV
Zip : 89511-7508
Country : US
Telephone Number : 775-329-0500
Fax Number : 775-329-4608
Provider Business Practice Location Address
First Line : 740 DEL MONTE LN#1
Second Line :
City : RENO
State : NV
Zip : 89511-7508
Country : US
Telephone Number : 775-329-0500
Fax Number : 775-329-4608
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/24/2005
Last Update Date : 08/05/2019

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