Active NPI
Blair R Hale, DMD
- Dentist
- Las Vegas, NV
National Provider Identifier
1083780720
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 0883
- Practice address
- 1700 W Charleston Blvd
Las Vegas, NV 89106 - Phone
- (702) 774-2816
- Fax
- (702) 774-2811
- NPI assigned
- Nov 27, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 0883 | NV | Primary |
Addresses
Primary practice location
1700 W Charleston Blvd
Las Vegas, NV 89106
Mailing address
1001 Shadow Lane
A103
Las Vegas, NV 89106
Phone (702) 774-2816
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0883 | NV | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Board of Regents, Nevada System of Higher Education | 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.
-
- Student in an Organized Health Care Education/Training Program
- Las Vegas, NV
- NPI 1053414862
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1164585600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1083780720",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1001 SHADOW LANE",
"address_2": "A103",
"city": "LAS VEGAS",
"state": "NV",
"postal_code": "89106",
"telephone_number": "702-774-2816",
"fax_number": "702-774-2811"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1700 W CHARLESTON BLVD",
"city": "LAS VEGAS",
"state": "NV",
"postal_code": "89106",
"telephone_number": "702-774-2816",
"fax_number": "702-774-2811"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HALE",
"first_name": "BLAIR",
"middle_name": "R",
"name_prefix": "Dr.",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-11-27",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "NV",
"license": "0883",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Las Vegas, NV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.