Individual provider Active NPI

Robert Joseph Hanlon Jr., DMD

  • Endodontics
  • Escondido, CA
National Provider Identifier
1194892380
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
EndodonticsTaxonomy code 1223E0200X
License
43444 Issued in CA
Practice address
488 East Valley Parkway
Suite 307
Escondido, CA 92025-3373
Phone
(760) 739-1400
Fax
(760) 739-1100
NPI assigned
Nov 30, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Endodontics 1223E0200X 43444 CA Primary

Addresses

Primary practice location

488 East Valley Parkway
Suite 307
Escondido, CA 92025-3373

Mailing address

488 East Valley Parkway
Suite 307
Escondido, CA 92025-3373
Phone (760) 739-1400

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20150512003080 CA Order and Referring Only - Other (Non-Physician) 6709106891

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
CMG Dental Partnership Endodontics Past Accepting new patients
Escondido Endodontics Inc Endodontics Past Accepting new patients

Organizations & group practices 2

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": "1164844800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1194892380",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "488 EAST VALLEY PARKWAY",
            "address_2": "SUITE 307",
            "city": "ESCONDIDO",
            "state": "CA",
            "postal_code": "920253373",
            "telephone_number": "760-739-1400",
            "fax_number": "760-739-1100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "488 EAST VALLEY PARKWAY",
            "address_2": "SUITE 307",
            "city": "ESCONDIDO",
            "state": "CA",
            "postal_code": "920253373",
            "telephone_number": "760-739-1400",
            "fax_number": "760-739-1100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HANLON",
        "first_name": "ROBERT",
        "middle_name": "JOSEPH",
        "name_suffix": "Jr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-30",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "CA",
            "license": "43444",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Escondido, CA

Sources for this page

Verify at the official NPI Registry.