Provider Demographics
NPI:1003485616
Name:KLAASSEN, HANNAH (DDS)
Entity Type:Individual
Prefix:DR
First Name:HANNAH
Middle Name:
Last Name:KLAASSEN
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:306 1ST AVE APT 403
Mailing Address - Street 2:
Mailing Address - City:CORALVILLE
Mailing Address - State:IA
Mailing Address - Zip Code:52241-2480
Mailing Address - Country:US
Mailing Address - Phone:816-390-2004
Mailing Address - Fax:
Practice Address - Street 1:4090 21ST AVE SW
Practice Address - Street 2:
Practice Address - City:CEDAR RAPIDS
Practice Address - State:IA
Practice Address - Zip Code:52404-6308
Practice Address - Country:US
Practice Address - Phone:319-396-5336
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-18
Last Update Date:2021-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IADDS-09914122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist