Randall James Hodoval, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

019017621 Issued in IL

Practice address

14955 S Van Dyke Rd
Unit100
Plainfield, IL 60544-5804

Phone

(815) 436-4900

Fax

(815) 436-6139

NPI assigned

Nov 13, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

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.

• Dental Associates of Plainfield P.C.

  • General Practice Dentistry
  • Plainfield, IL
  • NPI 1184796948
  NPD (past) Authorized official

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

{
    "created_epoch": "1163376000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1273017600000",
    "number": "1457422305",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14955 S VAN DYKE RD",
            "address_2": "UNIT100",
            "city": "PLAINFIELD",
            "state": "IL",
            "postal_code": "605445804",
            "telephone_number": "815-436-4900",
            "fax_number": "815-436-6139"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14955 S VAN DYKE RD",
            "address_2": "UNIT100",
            "city": "PLAINFIELD",
            "state": "IL",
            "postal_code": "605445804",
            "telephone_number": "815-436-4900",
            "fax_number": "815-436-6139"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HODOVAL",
        "first_name": "RANDALL",
        "middle_name": "JAMES",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-13",
        "last_updated": "2010-05-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019017621",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Hines VA Hospital
• Julie Hiskes, COTA/L
• Calyssa Hitt
• Megan Hoak
• Tatianna Hodgen, RBT
• Michele Latrice Hoffman, MS.,CCC/SLP
• Ronald Franklin Hohl, DDS
• Roxanne Holley
• Tayler Holley
• Makenzie Hollis, MS SLP

• General Practice Dentistry in Plainfield, IL
• Providers in Plainfield, IL by specialty
• General Practice Dentistry in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2010; 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.