Individual provider Active NPI

Richard A Woldman, DDS

  • General Practice Dentistry
  • Hoffman Estates, IL
National Provider Identifier
1154594166
Registry record updated Apr 10, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Practice address
990 Grand Canyon Pkwy
215
Hoffman Estates, IL 60169-1739
Phone
(847) 885-1680
Fax
(847) 885-4203
NPI assigned
Apr 10, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 10, 2008

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 IL Primary

Addresses

Primary practice location

990 Grand Canyon Pkwy
215
Hoffman Estates, IL 60169-1739

Mailing address

990 Grand Canyon Pkwy
Hoffman Estates, IL 60169-1739
Phone (847) 885-1680

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150616001012 IL Order and Referring Only - Other (Non-Physician) 6901129626

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
019-014440ILMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
DRS Woldman and Rizman LTD General Practice PastSince Jun 2, 1976 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1207785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1207785600000",
    "number": "1154594166",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "990 GRAND CANYON PKWY",
            "city": "HOFFMAN ESTATES",
            "state": "IL",
            "postal_code": "601691739",
            "telephone_number": "847-885-1680",
            "fax_number": "847-885-4203"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "990 GRAND CANYON PKWY",
            "address_2": "215",
            "city": "HOFFMAN ESTATES",
            "state": "IL",
            "postal_code": "601691739",
            "telephone_number": "847-885-1680",
            "fax_number": "847-885-4203"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOLDMAN",
        "first_name": "RICHARD",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-04-10",
        "last_updated": "2008-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hoffman Estates, IL

Sources for this page

Verify at the official NPI Registry.