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DR. RANDAL L. HILLIS DDS
NPI 1710933353
Dentist in Poplar Bluff, MO

Active since May 25, 2006Opted out of Medicare · through Jul 2, 2027
1600 WEST HARPER STREET, POPLAR BLUFF, MO 63901(573) 785-6699(573) 785-3424 Get Directions Write a Review

NPPES record last updated: July 8, 2019. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Dr. Randal L. Hillis Dds NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. RANDAL L. HILLIS DDS (NPI 1710933353) is an individual dentist in Poplar Bluff, Missouri, licensed in Missouri (14340) and active in the NPI registry since May 2006. He has opted out of Medicare through July 2, 2027 and remains eligible to order and refer.

NPPES Registry Identity

NPI1710933353
Entity TypeIndividualMale
Primary Taxonomy122300000X
Provider Legal NameDR. RANDAL L. HILLISCredential: DDS
Location Address1600 WEST HARPER STREETPoplar Bluff, MO 63901-4119
Mailing Address1600 West Harper StreetPoplar Bluff, MO 63901-4119 · (573) 785-6699 · Fax (573) 785-3424
Phone(573) 785-6699
Fax(573) 785-3424
Sole ProprietorYes
Enumeration DateMay 25, 2006
Last NPPES UpdateJuly 8, 2019
✔ NPI 1710933353 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentistDental Providers
Taxonomy Code122300000X
License✔ Licensed in MO · 14340
Definition
A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist.
1600 WEST HARPER STREET, Poplar Bluff, MO 63901
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

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Opted out of Medicare

Dr. Randal L. Hillis Dds has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from July 2, 2019 through July 2, 2027.

Opt-Out Effective DateJuly 2, 2019
Opt-Out In Effect ThroughJuly 2, 2027Opt-out affidavits renew automatically every two years unless cancelled
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency– Power Mobility DevicesAn opted-out provider can still order and refer for Medicare patients in the categories marked above, even though their own services are not covered.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 63901 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$81.64 typical visit price
range $52.28 – $161.24
Typical copayment $20.41 (range $13.07 – $40.31)
Most-billed visit code 99203
Established Patient
$65.71 typical visit price
range $16.30 – $131.05
Typical copayment $16.42 (range $4.07 – $32.76)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Randal Hillis's NPI number?

The NPI number for Randal Hillis is 1710933353. It was assigned to this individual provider in the NPPES registry on May 25, 2006.

Where is Randal Hillis located?

Randal Hillis practices at 1600 West Harper Street, Poplar Bluff, MO 63901. The listed phone number is (573) 785-6699.

What is Randal Hillis's specialty?

The primary specialty registered for this NPI is Dentist with taxonomy code 122300000X.

Is Randal Hillis enrolled in Medicare?

No. Randal Hillis has opted out of Medicare through July 2, 2027. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out. The provider remains eligible to order and refer services for Medicare patients.

When was this NPI record last updated?

The NPPES record for Randal Hillis was last updated on July 8, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.