Oakdale Dental PC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

8001 Issued in IA

Legal business name

OAKDALE DENTAL PC

Practice address

2441 Coral CT Ste 5
Coralville, IA 52241-2872

Phone

(319) 545-6251

Fax

(319) 545-7265

NPI assigned

Jul 23, 2007

Last updated

Jul 23, 2007By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Chad R Hanneman, DDSNPI 1902023450

Title

President

Phone

(319) 545-6251

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Chad Raymond Hanneman, DDS

  • General Practice Dentistry
  • Coralville, IA
  • NPI 1902023450
  NPD (past) Authorized official

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

{
    "created_epoch": "1185148800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1185148800000",
    "number": "1578763090",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2441 CORAL CT STE 5",
            "city": "CORALVILLE",
            "state": "IA",
            "postal_code": "522412872",
            "telephone_number": "319-545-6251",
            "fax_number": "319-545-7265"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2441 CORAL CT STE 5",
            "city": "CORALVILLE",
            "state": "IA",
            "postal_code": "522412872",
            "telephone_number": "319-545-6251",
            "fax_number": "319-545-7265"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OAKDALE DENTAL PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-23",
        "last_updated": "2007-07-23",
        "status": "A",
        "authorized_official_last_name": "HANNEMAN",
        "authorized_official_first_name": "CHAD",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "319-545-6251",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IA",
            "license": "8001",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1219089",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Colin James O'Brien, M.D.
• Edward R O'Brien, D.O.
• Helga-Margot Aldape O'Brien, DNP, PMHNP-BC, ARNP
• Shannon O'Leary, PHARMD
• Mackenzie O'Neil
• Obstetric and Gynecologic Associates of Iowa City PC
• Tara Ohrt, PHD, HSP
• Jill M. Okken, PHARMD
• Stacia Olson, DPT
• Omaha Vamc

• General Practice Dentistry in Coralville, IA
• Providers in Coralville, IA by specialty
• General Practice Dentistry in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2007; 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.