Active NPI
Raymond Gilbert Hatland, D.D.S.
- Dentist
- Lincolnwood, IL
National Provider Identifier
1770770182
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 019013050
- Practice address
- 6453 N Lincoln Ave
Lincolnwood, IL 60712-4000 - Phone
- (773) 338-4440
- Fax
- (773) 338-4442
- NPI assigned
- Sep 29, 2007
- Last updated
- May 21, 2023
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 019013050 | IL | Primary |
Addresses
Primary practice location
6453 N Lincoln Ave
Lincolnwood, IL 60712-4000
Mailing address
6453 N Lincoln Ave
Lincolnwood, IL 60712-4000
Phone (773) 338-4440
Other practice location 1
6202 Broadway St
Indianapolis, IN 46220-1837
Phone (317) 257-0794
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
| License | State | Type | Specialty |
|---|---|---|---|
| 019013050 | IL | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Fildent Inc | Past | Accepting new patients | |
| Dr. Raymond G. Hatland | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- General Practice Dentistry
- Indianapolis, IN
- NPI 1235386764
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1191024000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1684627200000",
"number": "1770770182",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6453 N LINCOLN AVE",
"city": "LINCOLNWOOD",
"state": "IL",
"postal_code": "607124000",
"telephone_number": "773-338-4440",
"fax_number": "773-338-4442"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6453 N LINCOLN AVE",
"city": "LINCOLNWOOD",
"state": "IL",
"postal_code": "607124000",
"telephone_number": "773-338-4440",
"fax_number": "773-338-4442"
}
],
"practiceLocations": [
{
"address_1": "6202 Broadway St",
"address_purpose": "LOCATION",
"city": "Indianapolis",
"state": "IN",
"postal_code": "462201837",
"country_code": "US",
"telephone_number": "317-257-0794",
"fax_number": "317-254-0596",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "HATLAND",
"first_name": "RAYMOND",
"middle_name": "GILBERT",
"name_prefix": "Mr.",
"credential": "D.D.S.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-09-29",
"last_updated": "2023-05-21",
"certification_date": "2023-05-21",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "IL",
"license": "019013050",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lincolnwood, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.