Michael Jordan Halcomb, DDS

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

License

D011212 Issued in AZ

Practice address

22480 E Ocotillo Rd
Suite 102
Queen Creek, AZ 85142

Phone

(480) 404-9311

NPI assigned

May 22, 2019

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Halcomb Orthodontics LLC

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Queen Creek, AZ
  • NPI 1447967492
  NPD Authorized official

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

{
    "created_epoch": "1558483200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667779200000",
    "number": "1174180574",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2542 E HALE ST",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852134104",
            "telephone_number": "480-398-0206"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22480 E OCOTILLO RD",
            "address_2": "SUITE 102",
            "city": "QUEEN CREEK",
            "state": "AZ",
            "postal_code": "85142",
            "telephone_number": "480-404-9311"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "36275 N Gantzel Rd Ste 101",
            "address_purpose": "LOCATION",
            "city": "San Tan Valley",
            "state": "AZ",
            "postal_code": "851407320",
            "country_code": "US",
            "telephone_number": "480-404-9311",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HALCOMB",
        "first_name": "MICHAEL",
        "middle_name": "JORDAN",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-05-22",
        "last_updated": "2022-11-07",
        "certification_date": "2022-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "AZ",
            "license": "D011212",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gabrielle Guzman
• Ashley Grace Gyory
• Katherine Hakeman, MSN, FNP
• Misagh Hakimian, RPH
• Halcomb Orthodontics LLC
• Flint C Hales, MD
• Aubri Hall
• Rebecca Rose Halstead, LAT
• Brenton Hamann, PT
• Sharee C Hamblin, RN

• Orthodontics and Dentofacial Orthopedics Dentistry in Queen Creek, AZ
• Providers in Queen Creek, AZ by specialty
• Orthodontics and Dentofacial Orthopedics Dentistry in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2022; 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.