Individual provider Active NPI

Michael G Hoffman, DDS

  • General Practice Dentistry
  • Frankfort, IL
National Provider Identifier
1023116175
Registry record updated Dec 17, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
019-018638 Issued in IL
Practice address
600 Bankview Dr Ste B
Frankfort, IL 60423-1490
Phone
(815) 469-3377
Fax
(815) 469-3370
NPI assigned
Sep 20, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 17, 2014

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 019-018638 IL Primary

Addresses

Primary practice location

600 Bankview Dr Ste B
Frankfort, IL 60423-1490

Mailing address

600 Bankview Dr Ste B
Frankfort, IL 60423-1490
Phone (815) 469-3377

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20141230001859 IL Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 1052634888

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
019-018638ILMDGeneral Practice Dentistry

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1418774400000",
    "number": "1023116175",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 BANKVIEW DR STE B",
            "city": "FRANKFORT",
            "state": "IL",
            "postal_code": "604231490",
            "telephone_number": "815-469-3377",
            "fax_number": "815-469-3370"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 BANKVIEW DR STE B",
            "city": "FRANKFORT",
            "state": "IL",
            "postal_code": "604231490",
            "telephone_number": "815-469-3377",
            "fax_number": "815-469-3370"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOFFMAN",
        "first_name": "MICHAEL",
        "middle_name": "G",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-20",
        "last_updated": "2014-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019-018638",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Frankfort, IL

Sources for this page

Verify at the official NPI Registry.