Provider Demographics
NPI:1962363630
Name:HANSEN DMD AND HAWKINS DMD PLLC
Entity type:Organization
Organization Name:HANSEN DMD AND HAWKINS DMD PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:WESLEY
Authorized Official - Last Name:HANSEN
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:509-440-1238
Mailing Address - Street 1:1363 COLUMBIA PARK TRL STE 201
Mailing Address - Street 2:
Mailing Address - City:RICHLAND
Mailing Address - State:WA
Mailing Address - Zip Code:99352-4770
Mailing Address - Country:US
Mailing Address - Phone:509-735-9735
Mailing Address - Fax:509-735-9598
Practice Address - Street 1:1363 COLUMBIA PARK TRL STE 201
Practice Address - Street 2:
Practice Address - City:RICHLAND
Practice Address - State:WA
Practice Address - Zip Code:99352-4770
Practice Address - Country:US
Practice Address - Phone:509-735-9735
Practice Address - Fax:509-735-9598
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-11-20
Last Update Date:2025-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223E0200XDental ProvidersDentistEndodonticsGroup - Single Specialty