Individual provider Active NPI

Darlene C Hildebrand, DMD

  • General Practice Dentistry
  • Marshall, IL
National Provider Identifier
1063537769
Registry record updated Jun 15, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
019024998 Issued in IL
Practice address
414 N 6TH St
Marshall, IL 62441-1218
Phone
(217) 826-5723
NPI assigned
Mar 20, 2007
Last updated
Jun 15, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 15, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 019024998 IL Primary
General Practice Dentistry 1223G0001X 12012533A IN

Addresses

Primary practice location

414 N 6TH St
Marshall, IL 62441-1218

Mailing address

414 N 6TH St
Marshall, IL 62441-1218
Phone (217) 826-5723

Other practice location 1

3309 S 7th St
Terre Haute, IN 47802-4014
Phone (812) 232-4837

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
I20160217000490 IL Order and Referring Only - DentistPractitioner - Dentist 6406952118

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
12012533AINMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1174348800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1592179200000",
    "number": "1063537769",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "414 N 6TH ST",
            "city": "MARSHALL",
            "state": "IL",
            "postal_code": "624411218",
            "telephone_number": "217-826-5723"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "414 N 6TH ST",
            "city": "MARSHALL",
            "state": "IL",
            "postal_code": "624411218",
            "telephone_number": "217-826-5723"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3309 S 7th St",
            "address_purpose": "LOCATION",
            "city": "Terre Haute",
            "state": "IN",
            "postal_code": "478024014",
            "country_code": "US",
            "telephone_number": "812-232-4837",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HILDEBRAND",
        "first_name": "DARLENE",
        "middle_name": "C",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-20",
        "last_updated": "2020-06-15",
        "certification_date": "2020-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019024998",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IN",
            "license": "12012533A",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marshall, IL

Sources for this page

Verify at the official NPI Registry.