Provider Demographics
NPI:1083810121
Name:HANSING, FREDERICK CHRISTOPHER (DDS)
Entity Type:Individual
Prefix:DR
First Name:FREDERICK
Middle Name:CHRISTOPHER
Last Name:HANSING
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18740 VENTURA BLVD
Mailing Address - Street 2:SUITE 305
Mailing Address - City:TARZANA
Mailing Address - State:CA
Mailing Address - Zip Code:91356-3366
Mailing Address - Country:US
Mailing Address - Phone:818-609-1777
Mailing Address - Fax:818-609-9352
Practice Address - Street 1:18740 VENTURA BLVD
Practice Address - Street 2:SUITE 305
Practice Address - City:TARZANA
Practice Address - State:CA
Practice Address - Zip Code:91356-3366
Practice Address - Country:US
Practice Address - Phone:818-609-1777
Practice Address - Fax:818-609-9352
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA349701223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice