Individual provider Active NPI

Julia Ann Hallisy, DDS

  • Dentist
  • San Francisco, CA
National Provider Identifier
1124056841
Registry record updated Dec 14, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
36659 Issued in CA
Practice address
345 West Portal Ave
# 210
San Francisco, CA 94127
Phone
(415) 681-1011
Fax
(415) 681-1022
NPI assigned
Jun 29, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 14, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 36659 CA Primary

Addresses

Primary practice location

345 West Portal Ave
# 210
San Francisco, CA 94127

Mailing address

345 West Portal Ave
# 210
San Francisco, CA 94127
Phone (415) 681-1011

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150720001485 CA Order and Referring Only - DentistPractitioner - Dentist 7315250354

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Julia a. Hallisy D.D.S., Inc. Current Accepting new patients

Locations

345 West Portal Ave
Ste 210
San Francisco, CA 94127
Phone (415) 681-1011

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.

NPI Registry JSON

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

{
    "created_epoch": "1151539200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1481673600000",
    "number": "1124056841",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "345 WEST PORTAL AVE",
            "address_2": "# 210",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "94127",
            "telephone_number": "415-681-1011",
            "fax_number": "415-681-1022"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "345 WEST PORTAL AVE",
            "address_2": "# 210",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "94127",
            "telephone_number": "415-681-1011",
            "fax_number": "415-681-1022"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HALLISY",
        "first_name": "JULIA",
        "middle_name": "ANN",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-29",
        "last_updated": "2016-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "36659",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Francisco, CA

Sources for this page

Verify at the official NPI Registry.