Randall David Bell, DMD
Individual provider Active NPI General Practice Dentistry · Harrisburg, IL
NPI 1093775652 · NPPES record last updated Apr 19, 2016
Key facts
- NPI
- 1093775652
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Dentistry 1223G0001X
- License
- 19015346 (IL)
- Practice address
- 205 N Main St
Harrisburg, IL 62946-1272 - Phone
- (618) 253-8450
- Fax
- (618) 253-8454
- NPI assigned
- Mar 27, 2006
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 19015346 | IL | MD | General Practice Dentistry |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 19015346 | IL | Yes |
Addresses
Primary practice location
205 N Main St
Harrisburg, IL 62946-1272
Mailing address
205 N Main St
PO Box 233
Harrisburg, IL 62946-1256
Phone (618) 253-8450
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1004444 | Medicaid | IL |
Other providers in Harrisburg, IL
- Danielle Baker
- Stephan Barnard
- Joseph Baxter
- Sydney Beaupre
- Elizabeth Ann Bebout
- Ty D Biggs
- Bio-Medical Applications of Illinois, Inc.
- Sarah Bittle
- Farrah Renee Blair
- Ella Corrine Bosler
All providers in Harrisburg, IL · General Practice Dentistry in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 19, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.