Provider Demographics
NPI:1225775976
Name:ISAAC HANSET, DMD, LLC
Entity Type:Organization
Organization Name:ISAAC HANSET, DMD, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:
Authorized Official - First Name:ISAAC
Authorized Official - Middle Name:LEON
Authorized Official - Last Name:HANSET
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:503-484-7013
Mailing Address - Street 1:7745 CHERRY RIVER DR
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89145-4918
Mailing Address - Country:US
Mailing Address - Phone:503-484-7013
Mailing Address - Fax:
Practice Address - Street 1:1201 SE 223RD AVE STE 260
Practice Address - Street 2:
Practice Address - City:GRESHAM
Practice Address - State:OR
Practice Address - Zip Code:97030-2580
Practice Address - Country:US
Practice Address - Phone:503-484-7013
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-05-15
Last Update Date:2022-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental