Individual provider Active NPI

Vickie Lynn Hemann, DDS

  • Pediatric Dentistry
  • Urbana, IL
National Provider Identifier
1295877918
Registry record updated Oct 31, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
021.002306 Issued in IL
Practice address
1209 E Colorado Ave Ste 102
Urbana, IL 61801-6393
Phone
(217) 337-6000
Fax
(217) 337-6624
NPI assigned
Feb 12, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 31, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Dentistry 1223P0221X 019-024301 IL
Pediatric Dentistry 1223P0221X 021.002306 IL Primary

Addresses

Primary practice location

1209 E Colorado Ave Ste 102
Urbana, IL 61801-6393

Mailing address

1209 E Colorado Ave Ste 102
Urbana, IL 61801-6393
Phone (217) 337-6000

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
019-024301ILMDPediatric Dentist
021.002306ILMDPediatric Dentist

NPI Registry JSON

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

{
    "created_epoch": "1171238400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667174400000",
    "number": "1295877918",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1209 E COLORADO AVE STE 102",
            "city": "URBANA",
            "state": "IL",
            "postal_code": "618016393",
            "telephone_number": "217-337-6000",
            "fax_number": "217-337-6624"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1209 E COLORADO AVE STE 102",
            "city": "URBANA",
            "state": "IL",
            "postal_code": "618016393",
            "telephone_number": "217-337-6000",
            "fax_number": "217-337-6624"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEMANN",
        "first_name": "VICKIE",
        "middle_name": "LYNN",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-12",
        "last_updated": "2022-10-31",
        "certification_date": "2022-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "IL",
            "license": "019-024301",
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "IL",
            "license": "021.002306",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Urbana, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2022; 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.