Provider Demographics
NPI:1457024820
Name:HANSON, MEGAN SHORT (DDS)
Entity Type:Individual
Prefix:
First Name:MEGAN
Middle Name:SHORT
Last Name:HANSON
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 1:1450 PEBBLE WAY
Mailing Address - Street 2:
Mailing Address - City:ALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:75013-5119
Mailing Address - Country:US
Mailing Address - Phone:832-746-7862
Mailing Address - Fax:
Practice Address - Street 1:5400 W PLANO PKWY STE 250
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75093-4854
Practice Address - Country:US
Practice Address - Phone:972-732-1400
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-30
Last Update Date:2021-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX358791223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics