Individual provider Active NPI

Rachel Honard, DDS

  • General Practice Dentistry
  • Maywood, IL
National Provider Identifier
1134823347
Registry record updated Sep 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
018.002254 Issued in IL
Practice address
2160 S 1St Ave
Maywood, IL 60153-3328
Phone
(888) 584-7888
NPI assigned
Mar 30, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 13, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
General Practice Dentistry 1223G0001X 018.002254 IL Primary

Addresses

Primary practice location

2160 S 1St Ave
Maywood, IL 60153-3328

Mailing address

626 Fieldstone Dr
Erie, PA 16509-8226
Phone (814) 602-7784

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
I20231018001451 IL Order and Referring Only - DentistPractitioner - Dentist 8820443351

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
018.002254ILMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1680134400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694563200000",
    "number": "1134823347",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "626 FIELDSTONE DR",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165098226",
            "telephone_number": "814-602-7784"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2160 S 1ST AVE",
            "city": "MAYWOOD",
            "state": "IL",
            "postal_code": "601533328",
            "telephone_number": "888-584-7888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HONARD",
        "first_name": "RACHEL",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-03-30",
        "last_updated": "2023-09-13",
        "certification_date": "2023-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "018.002254",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Maywood, IL

Sources for this page

Verify at the official NPI Registry.