Individual provider Active NPI

Samantha Rae Lanham, RDH

  • Dental Hygienist
  • Downers Grove, IL
National Provider Identifier
1235407495
Registry record updated Dec 2, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental HygienistTaxonomy code 124Q00000X
License
020.013605 Issued in IL
Practice address
6800 Main St Ste 315
Downers Grove, IL 60516-3478
Phone
(630) 343-5296
NPI assigned
Dec 2, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 2, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Hygienist 124Q00000X 020.013605 IL Primary

Addresses

Primary practice location

6800 Main St Ste 315
Downers Grove, IL 60516-3478

Mailing address

6824 White Egret CT
Tinley Park, IL 60477-3974

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
020.013605ILMDDental Hygienist

NPI Registry JSON

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

{
    "created_epoch": "1322784000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1322784000000",
    "number": "1235407495",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6824 WHITE EGRET CT",
            "city": "TINLEY PARK",
            "state": "IL",
            "postal_code": "604773974"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6800 MAIN ST STE 315",
            "city": "DOWNERS GROVE",
            "state": "IL",
            "postal_code": "605163478",
            "telephone_number": "630-343-5296"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LANHAM",
        "first_name": "SAMANTHA",
        "middle_name": "RAE",
        "name_prefix": "Miss",
        "credential": "RDH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-12-02",
        "last_updated": "2011-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "124Q00000X",
            "taxonomy_group": "",
            "desc": "Dental Hygienist",
            "state": "IL",
            "license": "020.013605",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Downers Grove, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2011; 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.