HALES DENTAL PRACTICE PC NPI 1790229383

NPI Information

NPI: 1790229383
Provider Name: HALES DENTAL PRACTICE, PC

Doing Business As: ANGELLIFT DENTAL CENTER

Classification: Clinic/Center - 261QD0000X
Entity Type: Organization

Specialization: Dental

Address:
781 NE 7TH ST
B
GRANTS PASS, OR
ZIP 97526
Phone: (541) 474-1100
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HALES DENTAL PRACTICE, PC is a dental clinic center in Grants Pass, OR. HALES DENTAL PRACTICE, PC NPI is 1790229383. The provider is registered as an organization entity type.
The provider Is Doing Business As Angellift Dental Center.

The provider's business location address is:

781 NE 7TH ST
B
GRANTS PASS, OR
ZIP 97526-654
Phone: (541) 474-1100
Fax: (541) 474-1103

The provider's authorized official is Jim B Hales .
The authorized official title is Dentist/owner and has the following contact phone number (541) 474-1100.

The enumeration date for this NPI number is 12/15/2016 and was last updated on 12/15/2016.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QD0000X	Clinic/Center	Dental	D6777	OREGON	Yes
2	305S00000X	Point of Service		D6777	OREGON	No

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	040241	MEDICAID	OREGON
2	6080140001	OTHER	OREGON	MEDICARE DME PTAN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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