Kevin Hall DDS Omfs PLLC

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

Legal business name

KEVIN HALL DDS OMFS PLLC

Practice address

2776 Cleveland Ave
Fort Myers, FL 33901-5864

Phone

(877) 667-7669

Fax

(405) 848-0033

NPI assigned

Oct 17, 2018

Organization subpart

No

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

Authorized official

Name

Kevin P Hall, DDS

Title

Owner

Phone

(877) 667-7669

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1539734400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1539734400000",
    "number": "1174099196",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 269070",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731269070",
            "telephone_number": "877-667-7669",
            "fax_number": "405-848-0033"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2776 CLEVELAND AVE",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339015864",
            "telephone_number": "877-667-7669",
            "fax_number": "405-848-0033"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KEVIN HALL DDS OMFS PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-10-17",
        "last_updated": "2018-10-17",
        "status": "A",
        "authorized_official_last_name": "HALL",
        "authorized_official_first_name": "KEVIN",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "877-667-7669",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Oral and Maxillofacial Surgery (Dentist) in Fort Myers, FL
• Providers in Fort Myers, FL by specialty
• Oral and Maxillofacial Surgery (Dentist) in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2018; 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.