Provider Demographics
NPI:1568517878
Name:HANSON, OLANDO ST CLARE (OLANDO HANSON)
Entity Type:Individual
Prefix:DR
First Name:OLANDO
Middle Name:ST CLARE
Last Name:HANSON
Suffix:
Gender:M
Credentials:OLANDO HANSON
Other - Prefix:DR
Other - First Name:OLANDO
Other - Middle Name:ST CLARE
Other - Last Name:HANSON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DDS
Mailing Address - Street 1:3451 QUAKER CT
Mailing Address - Street 2:
Mailing Address - City:FALLS CHURCH
Mailing Address - State:VA
Mailing Address - Zip Code:22042-3911
Mailing Address - Country:US
Mailing Address - Phone:716-400-2098
Mailing Address - Fax:
Practice Address - Street 1:5130 DUKE ST STE 4
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22304-2955
Practice Address - Country:US
Practice Address - Phone:703-370-6500
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-24
Last Update Date:2021-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0522021223G0001X
VA04014146351223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice