Devon Halberg, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

D12783 Issued in MN

Practice address

1632 Washington St NE
Minneapolis, MN 55413-1336

Phone

(612) 789-2853

Fax

(612) 767-3490

NPI assigned

May 20, 2010

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

Enrolled in MN

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Larson Dental LLC

  • Dentist
  • Minneapolis, MN
  • NPI 1922726280
  NPD (past)

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

{
    "created_epoch": "1274313600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1274313600000",
    "number": "1194044842",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1632 WASHINGTON ST NE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554131336",
            "telephone_number": "612-789-2853",
            "fax_number": "612-767-3490"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1632 WASHINGTON ST NE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554131336",
            "telephone_number": "612-789-2853",
            "fax_number": "612-767-3490"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HALBERG",
        "first_name": "DEVON",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-05-20",
        "last_updated": "2010-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MN",
            "license": "D12783",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Luann Hakel
• Hakimtransportation LLC
• Gwen Elise Wagstrom Halaas, M.D.
• Cayni Halane
• Hossam Fathi Halaweish
• Ian Halberg, PH.D., LP
• Julia Undine Halberg, MD, MPH, MS
• Molly Halbur
• Casey Charles Halcrow, PHARMD
• Halcyon Chiropractic and Wellness LLC

• Dentist in Minneapolis, MN
• Providers in Minneapolis, MN by specialty
• Dentist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2010; 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.

Verify at the official NPI Registry.