Active NPI
Hal M Lippard, DDS
- General Practice Dentistry
- Charlottesville, VA
National Provider Identifier
1093735862
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 0401005111
- Practice address
- 505 Faulconer Dr
Suite 1D
Charlottesville, VA 22903-4981 - Phone
- (434) 293-9311
- Fax
- (434) 293-2105
- NPI assigned
- Jul 21, 2006
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 0401005111 | VA | Primary |
Addresses
Primary practice location
505 Faulconer Dr
Suite 1D
Charlottesville, VA 22903-4981
Mailing address
505 Faulconer Dr
Suite 1D
Charlottesville, VA 22903-4981
Phone (434) 293-9311
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in PA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20161110001563 | PA | Order and Referring Only - Dentist | 4183903388 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0401005111 | VA | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Oral Wellness Center of Virginia PLLC | 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.
-
- Dental Clinic/Center
- Charlottesville, VA
- NPI 1003652207
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153440000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1093735862",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "505 FAULCONER DR",
"address_2": "SUITE 1D",
"city": "CHARLOTTESVILLE",
"state": "VA",
"postal_code": "229034981",
"telephone_number": "434-293-9311",
"fax_number": "434-293-2105"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "505 FAULCONER DR",
"address_2": "SUITE 1D",
"city": "CHARLOTTESVILLE",
"state": "VA",
"postal_code": "229034981",
"telephone_number": "434-293-9311",
"fax_number": "434-293-2105"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LIPPARD",
"first_name": "HAL",
"middle_name": "M",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-07-21",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "VA",
"license": "0401005111",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Charlottesville, VA
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.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.