Individual provider Active NPI

Alice Drannon Hale, DMD

  • Dentist
  • Aiken, SC
National Provider Identifier
1205032315
Registry record updated Oct 19, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
4338 Issued in SC
Practice address
10 Tea Olive CT
Aiken, SC 29803-4715
Phone
(803) 649-0516
Fax
(803) 649-0549
NPI assigned
Jun 25, 2007
Last updated
Oct 19, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 19, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 4338 SC Primary

Addresses

Primary practice location

10 Tea Olive CT
Aiken, SC 29803-4715

Mailing address

10 Tea Olive CT
Aiken, SC 29803-4715
Phone (803) 649-0516

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
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
I20150909002951 SC Order and Referring Only - DentistPractitioner - Dentist 5294042123

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4338SCMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Dr. Gary a. Waugh D.M.D., P.a. 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1182729600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666137600000",
    "number": "1205032315",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 TEA OLIVE CT",
            "city": "AIKEN",
            "state": "SC",
            "postal_code": "298034715",
            "telephone_number": "803-649-0516",
            "fax_number": "803-649-0549"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 TEA OLIVE CT",
            "city": "AIKEN",
            "state": "SC",
            "postal_code": "298034715",
            "telephone_number": "803-649-0516",
            "fax_number": "803-649-0549"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HALE",
        "first_name": "ALICE",
        "middle_name": "DRANNON",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-06-25",
        "last_updated": "2022-10-19",
        "certification_date": "2022-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "SC",
            "license": "4338",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Aiken, SC

Sources for this page

Verify at the official NPI Registry.