NPIMap

Organization Active NPI

Hanne Dental, Inc.

  • Dentist
  • Edwardsville, IL
National Provider Identifier
1972027878
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
019.024344 Issued in IL
Legal business name
HANNE DENTAL, INC.
Practice address
6655 Edwardsville Crossing Dr Ste D
Edwardsville, IL 62025-2708
Phone
(618) 972-8655
Fax
(618) 656-9701
NPI assigned
Aug 1, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Authorized official

Name
Sharon Hanne, DMDNPI 1649317702
Title
Owner
Phone
(618) 972-8655

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 122300000X 019.024344 IL Primary
General Practice DentistryGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223G0001X 015867 MO
Customized Equipment (DME) 332BC3200X 019.024344 IL

Addresses

Primary practice location

6655 Edwardsville Crossing Dr Ste D
Edwardsville, IL 62025-2708

Mailing address

6655 Edwardsville Crossing Dr Ste D
Edwardsville, IL 62025-2708
Phone (618) 972-8655

Other identifiers 1

IdentifierTypeStateIssuer
403393918MedicaidMO

National Provider Directory

National Provider Directory

Locations

6655 Edwardsville Crossing Dr
Ste D
Edwardsville, IL 62025
Phone (618) 972-8655

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1501545600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1972027878",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6655 EDWARDSVILLE CROSSING DR STE D",
            "city": "EDWARDSVILLE",
            "state": "IL",
            "postal_code": "620252708",
            "telephone_number": "618-972-8655",
            "fax_number": "618-656-9701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6655 EDWARDSVILLE CROSSING DR STE D",
            "city": "EDWARDSVILLE",
            "state": "IL",
            "postal_code": "620252708",
            "telephone_number": "618-972-8655",
            "fax_number": "618-656-9701"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HANNE DENTAL, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-08-01",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "HANNE",
        "authorized_official_first_name": "SHARON",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "618-972-8655",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "IL",
            "license": "019.024344",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "MO",
            "license": "015867",
            "primary": false
        },
        {
            "code": "332BC3200X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Customized Equipment",
            "state": "IL",
            "license": "019.024344",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "403393918",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Edwardsville, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.