Gregory Lane Hailey, D.D.S.

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

CA42472 Issued in CA

Practice address

8150 Greenback LN Ste 300
Fair Oaks, CA 95628-2505

Phone

(916) 723-1111

Fax

(916) 723-1112

NPI assigned

Jan 16, 2007

Last updated

Jan 5, 2024By the provider in NPPES

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 CA

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

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

{
    "created_epoch": "1168905600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704412800000",
    "number": "1275685976",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8150 GREENBACK LN STE 300",
            "city": "FAIR OAKS",
            "state": "CA",
            "postal_code": "956282505",
            "telephone_number": "916-723-1111",
            "fax_number": "916-723-1112"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8150 GREENBACK LN STE 300",
            "city": "FAIR OAKS",
            "state": "CA",
            "postal_code": "956282505",
            "telephone_number": "916-723-1111",
            "fax_number": "916-723-1112"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8035 Madison Ave Ste G1",
            "address_purpose": "LOCATION",
            "city": "Citrus Heights",
            "state": "CA",
            "postal_code": "956107949",
            "country_code": "US",
            "telephone_number": "916-965-5787",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HAILEY",
        "first_name": "GREGORY",
        "middle_name": "LANE",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-16",
        "last_updated": "2024-01-05",
        "certification_date": "2024-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "CA",
            "license": "CA42472",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Oral and Maxillofacial Surgery (Dentist) in Fair Oaks, CA
• Providers in Fair Oaks, CA by specialty
• Oral and Maxillofacial Surgery (Dentist) in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2024; 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.