Rodney H. Hillam, DDS, MS, PA

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

License

2019 Issued in ID

Practice address

3325 S. Holmes Ave.
Idaho Falls, ID 83404

Phone

(208) 524-1800

Fax

(208) 524-1890

NPI assigned

Oct 7, 2008

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science, Physician Assistant

State licenses

Practice roles

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.

• Rodney H Hillam DDS Ms PA

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Idaho Falls, ID
  • NPI 1306973862
  NPD (past) Authorized official
• Hillam Orthodontics PA

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Idaho Falls, ID
  • NPI 1437684099
  NPD (past)

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

{
    "created_epoch": "1223337600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1223337600000",
    "number": "1225289390",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3325 S. HOLMES AVE.",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "83404",
            "telephone_number": "208-524-1800",
            "fax_number": "208-524-1890"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3325 S. HOLMES AVE.",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "83404",
            "telephone_number": "208-524-1800",
            "fax_number": "208-524-1890"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HILLAM",
        "first_name": "RODNEY",
        "middle_name": "H.",
        "name_prefix": "Dr.",
        "credential": "DDS, MS, PA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-10-07",
        "last_updated": "2008-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "WY",
            "license": "113353500",
            "primary": false
        },
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "ID",
            "license": "2019",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS OF ID",
            "identifier": "60301",
            "state": "ID"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "002584200",
            "state": "ID"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED CONCORDIA",
            "identifier": "840380",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "113353500",
            "state": "WY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Melanie Hill, RDH, OMT
• Rebekah Hill, MOTR/L
• Hillam Orthodontics PA
• Jordan Rodney Hillam, D.D.S.
• Kirt Bruce Hillam, DDS
• Anna Himrich
• Daniel K Hinckley, M.D.
• Jesse Hinckley, MD, PHD
• Mark E Hinkson, D.O.
• Kerilyn Horton Hinman, M.S. CCC-SLP

• Orthodontics and Dentofacial Orthopedics Dentistry in Idaho Falls, ID
• Providers in Idaho Falls, ID by specialty
• Orthodontics and Dentofacial Orthopedics Dentistry in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.