Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Dr. Heidi J Hansen, DMD

Individual provider Dentist · NPI 1063655967

Dr. Heidi J Hansen, DMD is an Undefined Physician Type (Specify) in Portland, Oregon. Qualified in 2004, 22 years ago. Practices with Providence Health and Services Oregon, a 1,426-clinician group and accepts Medicare assignment. Licensed in New York and Oregon.

Years since qualifying
22
Licensed in
NY, OR
In the registry since
2009
Specialties on file
4
What do these letters mean?
DMD — Doctor of Dental Medicine
A dentist. Identical training and licensing to a DDS.

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Practice location Address checks out

4805 NE Glisan St Ste 11N
Portland, OR 97213-2933
Phone: (503) 215-1676
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Oral Medicine Dentistry (primary) Taxonomy 125Q00000X · Licence D11216 (OR)
Dentist Taxonomy 122300000X · Licence D11216 (OR)
Dentist Taxonomy 122300000X · Licence 055295 (NY)
Oral Medicine Dentistry Taxonomy 125Q00000X · Licence 055295 (NY)

Record details

NPI number1063655967
Entity typeIndividual (Type 1)
GenderFemale
Credentials DMD
Sole proprietorNo
NPI enumeratedApril 8, 2009
Last updated in NPPESOctober 23, 2023
Certification dateOctober 23, 2023

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyUNDEFINED PHYSICIAN TYPE (SPECIFY)
Medical schoolOTHER
Graduated 2004 (22 years in practice)
Group practice Providence Health And Services Oregon — 1426 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

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