Lonnie Bruce Hall I, DDS

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

22DIO13411800 Issued in NJ

Practice address

329 60TH St
West New York, NJ 07093-5497

Phone

(201) 868-0070

Fax

(201) 869-4030

NPI assigned

Mar 22, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1174521600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1043336597",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "329 60TH ST",
            "city": "WEST NEW YORK",
            "state": "NJ",
            "postal_code": "070935497",
            "telephone_number": "201-868-0070",
            "fax_number": "201-869-4030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "329 60TH ST",
            "city": "WEST NEW YORK",
            "state": "NJ",
            "postal_code": "070935497",
            "telephone_number": "201-868-0070",
            "fax_number": "201-869-4030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HALL",
        "first_name": "LONNIE",
        "middle_name": "BRUCE",
        "name_prefix": "Mr.",
        "name_suffix": "I",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-22",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "NJ",
            "license": "22DIO13411800",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0845108",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Pediatric Dentistry in West New York, NJ
• Providers in West New York, NJ by specialty
• Pediatric Dentistry in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; 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.