Individual provider Active NPI

Michelle Howard Rynn, DMD

  • Prosthodontics
  • Hines, IL
National Provider Identifier
1285948356
Registry record updated Jun 8, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
ProsthodonticsTaxonomy code 1223P0700X
License
019028370 Issued in IL
Practice address
5000 S 5TH Ave
Edward Hines Jr. VA Hospital Dental Service
Hines, IL 60141-3030
Phone
(708) 202-8387
Fax
(708) 202-7165
NPI assigned
Aug 1, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 8, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Prosthodontics 1223P0700X 019028370 IL Primary
Dentist 122300000X DEN.00202730 CO

Addresses

Primary practice location

5000 S 5TH Ave
Edward Hines Jr. VA Hospital Dental Service
Hines, IL 60141-3030

Mailing address

5000 S 5TH Ave
Edward Hines Jr. VA Hospital Dental Service
Hines, IL 60141-3030
Phone (708) 202-8387

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
DEN.00202730COMDDentist
019028370ILMDProsthodontist

NPI Registry JSON

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

{
    "created_epoch": "1280620800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1465344000000",
    "number": "1285948356",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5000 S 5TH AVE",
            "address_2": "EDWARD HINES JR. VA HOSPITAL DENTAL SERVICE",
            "city": "HINES",
            "state": "IL",
            "postal_code": "601413030",
            "telephone_number": "708-202-8387",
            "fax_number": "708-202-7165"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5000 S 5TH AVE",
            "address_2": "EDWARD HINES JR. VA HOSPITAL DENTAL SERVICE",
            "city": "HINES",
            "state": "IL",
            "postal_code": "601413030",
            "telephone_number": "708-202-8387",
            "fax_number": "708-202-7165"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RYNN",
        "first_name": "MICHELLE",
        "middle_name": "HOWARD",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-08-01",
        "last_updated": "2016-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0700X",
            "taxonomy_group": "",
            "desc": "Dentist, Prosthodontics",
            "state": "IL",
            "license": "019028370",
            "primary": true
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CO",
            "license": "DEN.00202730",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hines, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2016; 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.