Individual provider Active NPI

Richard Frank Heilemann, DDS

  • Dentist
  • Manchester Center, VT
National Provider Identifier
1033558309
Registry record updated Jun 20, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
00160000600 Issued in VT
Practice address
74 Long View Drive
Manchester Center, VT 05254
Phone
(802) 362-1099
Fax
(802) 362-1901
NPI assigned
Jun 20, 2013
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 20, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 00160000600 VT Primary

Addresses

Primary practice location

74 Long View Drive
Manchester Center, VT 05254

Mailing address

74 Long View Drive
Manchester, VT 05254
Phone (802) 362-1099

Other identifiers 1

IdentifierTypeStateIssuer
0001726MedicaidVT

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
00160000600VTMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1371686400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1371686400000",
    "number": "1033558309",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "74 LONG VIEW DRIVE",
            "city": "MANCHESTER",
            "state": "VT",
            "postal_code": "05254",
            "telephone_number": "802-362-1099",
            "fax_number": "802-362-1901"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "74 LONG VIEW DRIVE",
            "city": "MANCHESTER CENTER",
            "state": "VT",
            "postal_code": "05254",
            "telephone_number": "802-362-1099",
            "fax_number": "802-362-1901"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEILEMANN",
        "first_name": "RICHARD",
        "middle_name": "FRANK",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-06-20",
        "last_updated": "2013-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "VT",
            "license": "00160000600",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0001726",
            "state": "VT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Manchester Center, VT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.