Active NPI
Joseph S Hale, DMD
- Dentist
- Colorado Springs, CO
National Provider Identifier
1245467125
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 7749
- Practice address
- 1580 Space Center Dr
Suite 107
Colorado Springs, CO 80915-2445 - Phone
- (791) 574-8922
- NPI assigned
- Jun 17, 2009
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 10639 | CO | |
| Dentist | 122300000X | 7749 | AZ | Primary |
Addresses
Primary practice location
1580 Space Center Dr
Suite 107
Colorado Springs, CO 80915-2445
Mailing address
5222 Fraser Valley LN
Colorado Springs, CO 80924-8205
Phone (917) 660-0290
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CO
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160608000708 | CO | Order and Referring Only - Dentist | 9133419864 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 10639 | CO | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1245196800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1398038400000",
"number": "1245467125",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5222 FRASER VALLEY LN",
"city": "COLORADO SPRINGS",
"state": "CO",
"postal_code": "809248205",
"telephone_number": "917-660-0290"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1580 SPACE CENTER DR",
"address_2": "SUITE 107",
"city": "COLORADO SPRINGS",
"state": "CO",
"postal_code": "809152445",
"telephone_number": "791-574-8922"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HALE",
"first_name": "JOSEPH",
"middle_name": "S",
"name_prefix": "Dr.",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2009-06-17",
"last_updated": "2014-04-21",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "CO",
"license": "10639",
"primary": false
},
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "AZ",
"license": "7749",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Colorado Springs, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2014; 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.