Individual provider Active NPI

Rhonda Beth Hanser, DMD

  • Dentist
  • Troy, IL
National Provider Identifier
1992713846
Registry record updated Jan 22, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
019.022264 Issued in IL
Practice address
334 Bargraves Blvd
Troy, IL 62294
Phone
(618) 667-2004
Fax
(618) 667-2526
NPI assigned
Aug 4, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 22, 2010

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 019022264 IL
Dentist 122300000X 019.022264 IL Primary

Addresses

Primary practice location

334 Bargraves Blvd
Troy, IL 62294

Mailing address

334 Bargraves Blvd
Troy, IL 62294
Phone (618) 667-2004

Other identifiers 1

IdentifierTypeStateIssuer
1992713846OtherILBLUE CROSS BLUE SHIELD OF ILLINOIS

Other names 1

  • Rhonda Beth Miller Former name

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20141008002127 IL Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 5395965669

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
019.022264ILMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Hanser Dental, LLC Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1154649600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1264118400000",
    "number": "1992713846",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "334 BARGRAVES BLVD",
            "city": "TROY",
            "state": "IL",
            "postal_code": "62294",
            "telephone_number": "618-667-2004",
            "fax_number": "618-667-2526"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "334 BARGRAVES BLVD",
            "city": "TROY",
            "state": "IL",
            "postal_code": "62294",
            "telephone_number": "618-667-2004",
            "fax_number": "618-667-2526"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HANSER",
        "first_name": "RHONDA",
        "middle_name": "BETH",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-04",
        "last_updated": "2010-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IL",
            "license": "019022264",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IL",
            "license": "019.022264",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD OF ILLINOIS",
            "identifier": "1992713846",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "RHONDA",
            "last_name": "MILLER",
            "middle_name": "BETH",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Troy, IL

Sources for this page

Verify at the official NPI Registry.