Individual provider Active NPI

Brenda Lynn Hausman-Miller, D.D.S

  • General Practice Dentistry
  • Sioux City, IA
National Provider Identifier
1629058730
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
08142 Issued in IA
Practice address
1021 Nebraska St
Sioux City, IA 51105-1436
Phone
(712) 252-2477
NPI assigned
Jan 17, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 08142 IA Primary

Addresses

Primary practice location

1021 Nebraska St
Sioux City, IA 51105-1436

Mailing address

1021 Nebraska Street
PO Box 5410
Sioux City, IA 51102-5410
Phone (712) 252-2477

Other identifiers 1

IdentifierTypeStateIssuer
0092080MedicaidIA

Other names 1

  • Brenda Lynn Hausman Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA
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
I20160302000665 IA Order and Referring Only - DentistPractitioner - Dentist 2961707856

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Siouxland Community Health Center Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: bhausmanmiller637068@direct.ochin.org

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": "1137456000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1629058730",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1021 NEBRASKA STREET",
            "address_2": "PO BOX 5410",
            "city": "SIOUX CITY",
            "state": "IA",
            "postal_code": "511025410",
            "telephone_number": "712-252-2477"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1021 NEBRASKA ST",
            "city": "SIOUX CITY",
            "state": "IA",
            "postal_code": "511051436",
            "telephone_number": "712-252-2477"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAUSMAN-MILLER",
        "first_name": "BRENDA",
        "middle_name": "LYNN",
        "name_prefix": "Dr.",
        "credential": "D.D.S",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-17",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IA",
            "license": "08142",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0092080",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BRENDA",
            "last_name": "HAUSMAN",
            "middle_name": "LYNN",
            "credential": "D.D.S",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Sioux City, IA

Sources for this page

Verify at the official NPI Registry.