DR. OTTO JULIUS HANSSEN D.D.S.
NPI 1043365935
Dentist - General Practice in Bonney Lake, WA

Active since January 24, 2007PECOS Enrolled
21515 STATE ROUTE 410 E, SUITE A, BONNEY LAKE, WA 98391(253) 826-9000(253) 826-0328 Get Directions Write a Review

NPPES record last updated: July 8, 2007. Verified against the NPPES registry weekly; last sync: July 19, 2026.

About Dr. Otto Julius Hanssen D.d.s. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. OTTO JULIUS HANSSEN D.D.S. (NPI 1043365935) is an individual general practice provider in Bonney Lake, Washington, licensed in Washington (DE00005262) and active in the NPI registry since January 2007. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1043365935
Entity TypeIndividualMale
Primary Taxonomy1223G0001X
Provider Legal NameDR. OTTO JULIUS HANSSENCredential: D.D.S.
Location Address21515 STATE ROUTE 410 E, SUITE ABonney Lake, WA 98391-4100
Mailing Address21515 State Route 410 E, Suite ABonney Lake, WA 98391-4100 · (253) 826-9000 · Fax (253) 826-0328
Fax(253) 826-0328
Sole ProprietorYes
Enumeration DateJanuary 24, 2007
Last NPPES UpdateJuly 8, 2007
NPI 1043365935 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyDentist · General PracticeDental Providers
Taxonomy Code1223G0001X
License Licensed in WA · DE00005262
Definition

A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.

21515 STATE ROUTE 410 E, Bonney Lake, WA 98391

Accepted Insurance

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Opted out of Medicare

Dr. Otto Julius Hanssen D.d.s. has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from March 24, 2016 through March 24, 2026.

Opt-Out Effective DateMarch 24, 2016
Opt-Out In Effect ThroughMarch 24, 2026Opt-out affidavits renew automatically every two years unless cancelled
Eligible to Order & Refer Part B Labs & Imaging Durable Medical Equipment Home Health Agency Power Mobility DevicesAn opted-out provider can still order and refer for Medicare patients in the categories marked above, even though their own services are not covered.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 98391 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$88.29 typical visit price
range $57.27 – $172.80
Typical copayment $22.07 (range $14.31 – $43.20)
Most-billed visit code 99203
Established Patient
$71.29 typical visit price
range $18.56 – $141.11
Typical copayment $17.82 (range $4.64 – $35.27)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Dentist (General Practice)
21515 STATE ROUTE 410 E, SUITE A
BONNEY LAKE, WA 98391
Dentist (General Practice)
21515 STATE ROUTE 410 E, SUITE A
BONNEY LAKE, WA 98391

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1043365935, enumerated as an "individual" on January 24, 2007.

The provider is located at 21515 STATE ROUTE 410 E SUITE A BONNEY LAKE, WA 98391 and the phone number is (253) 826-9000.

Dentist with taxonomy code 1223G0001X and a focus in General Practice.

The provider might be accepting Accepts: Blue Cross and Blue Shield of Montana, Blue Cross. Please consult your insurance carrier or call the provider to verify.