Individual provider Active NPI

Lester William Henselman, DDS

  • Dentist
  • Northbrook, IL
National Provider Identifier
1669744587
Registry record updated Feb 8, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
019014214 Issued in IL
Practice address
1310 Shermer Rd
200
Northbrook, IL 60062-4579
Phone
(847) 272-2181
Fax
(847) 272-2390
NPI assigned
Feb 8, 2012
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 8, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 019014214 IL Primary

Addresses

Primary practice location

1310 Shermer Rd
200
Northbrook, IL 60062-4579

Mailing address

1310 Shermer Rd
200
Northbrook, IL 60062-4579
Phone (847) 272-2181

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
019014214ILMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
L W Henselman DDS PC 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": "1328659200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1328659200000",
    "number": "1669744587",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1310 SHERMER RD",
            "address_2": "200",
            "city": "NORTHBROOK",
            "state": "IL",
            "postal_code": "600624579",
            "telephone_number": "847-272-2181",
            "fax_number": "847-272-2390"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1310 SHERMER RD",
            "address_2": "200",
            "city": "NORTHBROOK",
            "state": "IL",
            "postal_code": "600624579",
            "telephone_number": "847-272-2181",
            "fax_number": "847-272-2390"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENSELMAN",
        "first_name": "LESTER",
        "middle_name": "WILLIAM",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-02-08",
        "last_updated": "2012-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IL",
            "license": "019014214",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Northbrook, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2012; 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.