Chad Raymond Hanneman, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

8001 Issued in IA

Practice address

2441 Coral Court #5
Coralville, IA 52241

Phone

(319) 545-6251

Fax

(319) 545-7265

NPI assigned

Apr 19, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not 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.

• Oakdale Dental PC

  • General Practice Dentistry
  • Coralville, IA
  • NPI 1578763090
  NPD (past) Authorized official

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

{
    "created_epoch": "1176940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1902023450",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2441 CORAL COURT #5",
            "city": "CORALVILLE",
            "state": "IA",
            "postal_code": "52241",
            "telephone_number": "319-545-6251",
            "fax_number": "319-545-7265"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2441 CORAL COURT #5",
            "city": "CORALVILLE",
            "state": "IA",
            "postal_code": "52241",
            "telephone_number": "319-545-6251",
            "fax_number": "319-545-7265"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HANNEMAN",
        "first_name": "CHAD",
        "middle_name": "RAYMOND",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IA",
            "license": "8001",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1219089",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "20737",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CONCORDIA",
            "identifier": "1382746",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Hammer Incorporated
• Dillon Edward Hammes, D.C.
• Mitchell Heawon Hampton, DDS
• Kila Haney
• Alex Hangartner, RPH
• Michael Hannig, PTA
• Kate Duchene Hanrahan, M.D.
• Cameron Clarice Hanson, LMSW
• Jared Hanus, DPT
• Nidal H Harb, M.D.

• General Practice Dentistry in Coralville, IA
• Providers in Coralville, IA by specialty
• General Practice Dentistry in Iowa

• 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.