Individual provider Active NPI

Robert David Horenkamp, DDS

  • Dentist
  • Bloomington, IL
National Provider Identifier
1639275308
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
Practice address
405 South Prospect Road
Bloomington, IL 61704
Phone
(309) 662-2833
Fax
(309) 662-7862
NPI assigned
Sep 16, 2006
Sex
Male
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
Dentist 122300000X IL Primary

Addresses

Primary practice location

405 South Prospect Road
Bloomington, IL 61704

Mailing address

405 South Prospect Road
Bloomington, IL 61704
Phone (309) 662-2833

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
019013846ILMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Sylvester Family Dental, LLC Dentist Past Accepting new patients

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": "1158364800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1639275308",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "405 SOUTH PROSPECT ROAD",
            "city": "BLOOMINGTON",
            "state": "IL",
            "postal_code": "61704",
            "telephone_number": "309-662-2833",
            "fax_number": "309-662-7862"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "405 SOUTH PROSPECT ROAD",
            "city": "BLOOMINGTON",
            "state": "IL",
            "postal_code": "61704",
            "telephone_number": "309-662-2833",
            "fax_number": "309-662-7862"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HORENKAMP",
        "first_name": "ROBERT",
        "middle_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-16",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bloomington, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.