Individual provider Active NPI

Daniel J Lehenbauer, DDS

  • Dentist
  • Brookfield, IL
National Provider Identifier
1255425476
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
Practice address
9224 Broadway
Brookfield, IL 60513
Phone
(708) 485-0340
Fax
(708) 485-0631
NPI assigned
Oct 3, 2006
Last updated
Jul 8, 2007By the provider in NPPES
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
Dentist 122300000X IL Primary

Addresses

Primary practice location

9224 Broadway
Brookfield, IL 60513

Mailing address

9224 Broadway
Brookfield, IL 60513
Phone (708) 485-0340

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
I20150213000508 IL Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 9436474467

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
A Advancements in Dental Care Dentist Past 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1159833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1255425476",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9224 BROADWAY",
            "city": "BROOKFIELD",
            "state": "IL",
            "postal_code": "60513",
            "telephone_number": "708-485-0340",
            "fax_number": "708-485-0631"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9224 BROADWAY",
            "city": "BROOKFIELD",
            "state": "IL",
            "postal_code": "60513",
            "telephone_number": "708-485-0340",
            "fax_number": "708-485-0631"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEHENBAUER",
        "first_name": "DANIEL",
        "middle_name": "J",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-03",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brookfield, IL

Sources for this page

Verify at the official NPI Registry.