Peri Lynn Hanawalt, D.M.D.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

60543 Issued in CA

Practice address

2450 D St
La Verne, CA 91750-4416

Phone

(909) 593-4581

NPI assigned

Jul 21, 2011

Last updated

Jul 21, 2011By the provider in NPPES

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 CA

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

Practice roles

Locations

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.

• Hanawalt Wes Dental Corporation

  • General Practice Dentistry
  • La Verne, CA
  • NPI 1427625581
  NPD
• Hanawalt Dental Corporation

  • General Practice Dentistry
  • La Verne, CA
  • NPI 1962890632
  NPD (past)

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

{
    "created_epoch": "1311206400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1311206400000",
    "number": "1780972984",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2450 D ST",
            "city": "LA VERNE",
            "state": "CA",
            "postal_code": "917504416",
            "telephone_number": "909-593-4581"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2450 D ST",
            "city": "LA VERNE",
            "state": "CA",
            "postal_code": "917504416",
            "telephone_number": "909-593-4581"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HANAWALT",
        "first_name": "PERI",
        "middle_name": "LYNN",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-07-21",
        "last_updated": "2011-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "60543",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Hakimzadeh and Reyhani Dental Corp (Pearl Dental Group)
• Susan L Haly, LMFT
• Ryan Patrick Hamann, PA
• Hanawalt Dental Corporation
• Hanawalt Wes Dental Corporation
• Roger M. Hanawalt, D.D.S.
• Mary Justina Hanna, OTR/L
• Susan Harman, FNP
• Nailah N Harris
• Sean Harris

• General Practice Dentistry in La Verne, CA
• Providers in La Verne, CA by specialty
• General Practice Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2011; 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.