Individual provider Active NPI

Brian Homann, D.D.S.

  • Dentist
  • Elk Grove Village, IL
National Provider Identifier
1508127853
Registry record updated Oct 16, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
019.028988 Issued in IL
Practice address
8 E Devon Ave
Elk Grove Village, IL 60007-3919
Phone
(847) 439-9440
NPI assigned
Jun 4, 2012
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 16, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 019.028988 IL Primary

Addresses

Primary practice location

8 E Devon Ave
Elk Grove Village, IL 60007-3919

Mailing address

8 E Devon Ave
Elk Grove Village, IL 60007-3919
Phone (847) 439-9440

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
I20150523000087 IL Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 5799005278

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
019.028988ILMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Brian Homann DDS, P.C. Dentist Current Accepting new patients

Locations

8 E Devon Ave
Elk Grove Vlg, IL 60007
Phone (847) 439-9440

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1338768000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1413417600000",
    "number": "1508127853",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8 E DEVON AVE",
            "city": "ELK GROVE VILLAGE",
            "state": "IL",
            "postal_code": "600073919",
            "telephone_number": "847-439-9440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8 E DEVON AVE",
            "city": "ELK GROVE VILLAGE",
            "state": "IL",
            "postal_code": "600073919",
            "telephone_number": "847-439-9440"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOMANN",
        "first_name": "BRIAN",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-06-04",
        "last_updated": "2014-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IL",
            "license": "019.028988",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elk Grove Village, IL

Sources for this page

Verify at the official NPI Registry.