Individual provider Active NPI

Hannah Randall, DDS

  • General Practice Dentistry
  • Garner, NC
National Provider Identifier
1508480815
Registry record updated Jun 2, 2020
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Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
11804 Issued in NC
Practice address
12450 Cleveland Rd Ste 201
Garner, NC 27529-8355
Phone
(919) 772-9927
NPI assigned
Jun 2, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 2, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 11804 NC Primary

Addresses

Primary practice location

12450 Cleveland Rd Ste 201
Garner, NC 27529-8355

Mailing address

14 Surrey Run
Asheville, NC 28803-8500
Phone (828) 777-8697

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20200716003245 NC Order and Referring Only - DentistPractitioner - Dentist 0749604270

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1591056000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1591056000000",
    "number": "1508480815",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14 SURREY RUN",
            "city": "ASHEVILLE",
            "state": "NC",
            "postal_code": "288038500",
            "telephone_number": "828-777-8697"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12450 CLEVELAND RD STE 201",
            "city": "GARNER",
            "state": "NC",
            "postal_code": "275298355",
            "telephone_number": "919-772-9927"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RANDALL",
        "first_name": "HANNAH",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-06-02",
        "last_updated": "2020-06-02",
        "certification_date": "2020-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NC",
            "license": "11804",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Garner, NC

Sources for this page

Verify at the official NPI Registry.