Brandon J Hissong, DMD

Primary specialty

DentistTaxonomy code 122300000X

Practice address

806 W Bridge St
Monticello, IL 61856-1038

Phone

(217) 762-7175

Fax

(217) 762-7845

NPI assigned

Jul 27, 2006

Last updated

Sep 24, 2007By the provider in NPPES

Sex

Male

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

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

{
    "created_epoch": "1153958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1190592000000",
    "number": "1952325417",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "806 W BRIDGE ST",
            "city": "MONTICELLO",
            "state": "IL",
            "postal_code": "618561038",
            "telephone_number": "217-762-7175",
            "fax_number": "217-762-7845"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "806 W BRIDGE ST",
            "city": "MONTICELLO",
            "state": "IL",
            "postal_code": "618561038",
            "telephone_number": "217-762-7175",
            "fax_number": "217-762-7845"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HISSONG",
        "first_name": "BRANDON",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-27",
        "last_updated": "2007-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mitchell Hammel, MD
• Jeffrey D. Hanley, IL.2474 BC-HIS 6946
• Michael Alan Harris, R.PH., MS, MBA
• Katelynn Nichole Hayes, APN
• Brittany Hicks, FNP
• Evelyn Huang, MD
• Mark Raymond Hudson, D.M.D.
• Illini Eyecare Monticello Inc
• David M Jahn, PAC
• John & Mary E Kirby Hospital

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2007; 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.