Sara Hanahan, DMD

Primary specialty

DentistTaxonomy code 122300000X

License

019.031175 Issued in IL

Practice address

4119 Humbert Rd
Alton, IL 62002-7116

Phone

(618) 465-8100

NPI assigned

Jul 18, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Moody Hanahan Dentistry LLC

  • Dental Clinic/Center
  • Alton, IL
  • NPI 1528693926
  NPD (past) Authorized official
• Humbert Road Dentistry

  • Dentist
  • Alton, IL
  • NPI 1942501911
  NPD (past)

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

{
    "created_epoch": "1500336000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1500336000000",
    "number": "1740703149",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1610 HENRY ST",
            "city": "ALTON",
            "state": "IL",
            "postal_code": "620023557",
            "telephone_number": "618-980-4675"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4119 HUMBERT RD",
            "city": "ALTON",
            "state": "IL",
            "postal_code": "620027116",
            "telephone_number": "618-465-8100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HANAHAN",
        "first_name": "SARA",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-07-18",
        "last_updated": "2017-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IL",
            "license": "019.031175",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Charles S. Halbeck, D.O.
• Charlotte Hall, RN
• Nicole Hall
• Abigail Hamilton, BSW
• Lindsey Hammond
• Rodger Hanko, M.D.
• Shelly Hanko, FNP
• Lindsay Hansard, MA,LPC
• Katherine Sue Hanser, DMD
• Amy S Hanson, LPC

• Dentist in Alton, IL
• Providers in Alton, IL by specialty
• Dentist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.