Tabitha Hanson, DMD

Primary specialty

DentistTaxonomy code 122300000X

License

019033725 Issued in IL

Practice address

815 N 2ND St
Marshall, IL 62441-1086

Phone

(217) 826-5181

NPI assigned

Jun 30, 2022

Last updated

Jun 30, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Restoration Dental LLC- Marshall Dental Professionals

  dba Marshall Dental Professionals

  • General Practice Dentistry
  • Marshall, IL
  • NPI 1326311630
  NPD (past)
• Restoration Dental LLC-Casey Family Dental

  dba Casey Family Dental

  • General Practice Dentistry
  • Casey, IL
  • NPI 1053684365
  NPD (past)

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

{
    "created_epoch": "1656547200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1656547200000",
    "number": "1356073993",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19882 N 2100TH ST",
            "city": "MARSHALL",
            "state": "IL",
            "postal_code": "624413529"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "815 N 2ND ST",
            "city": "MARSHALL",
            "state": "IL",
            "postal_code": "624411086",
            "telephone_number": "217-826-5181"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1400 E Main St",
            "address_purpose": "LOCATION",
            "city": "Casey",
            "state": "IL",
            "postal_code": "624202106",
            "country_code": "US",
            "telephone_number": "217-932-5266",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HANSON",
        "first_name": "TABITHA",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-06-30",
        "last_updated": "2022-06-30",
        "certification_date": "2022-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IL",
            "license": "019.033725",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IL",
            "license": "019033725",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Core Wellness Physical Therapy, PLLC
• County of Clark
• Anita Yvonne Eirhart, LMT
• Jessica Lynn Engledow, CCC-SLP
• Eyes on Main PLLC
• Chelsey Lee Hardiek, PHARMD
• Kelly Sue Hargis
• Haven Hospice Il LLC
• Darlene C Hildebrand, DMD
• Jacob Hoelscher, PHARMD

• Dentist in Marshall, IL
• Providers in Marshall, IL by specialty
• Dentist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 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.