Keith Hallaian, D.M.D., M.D.

Primary specialty

Oral and Maxillofacial Pathology DentistryTaxonomy code 1223P0106X

License

048248 Issued in NY

Practice address

80 Maple Ave
Smithtown, NY 11787-3520

Phone

(631) 265-6533

Fax

(631) 265-6723

NPI assigned

Feb 16, 2007

Last updated

Jul 8, 2007By 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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• 42 North Dental Oral Surgery of Ma, PLLC

  dba South Shore Oral Surgery Associates

  • Dental Clinic/Center
  • Quincy, MA
  • NPI 1730846403
  NPD (past)
• South Shore Oral Surgery Associates Co. Inc.

  • Oral and Maxillofacial Surgery (Dentist)
  • Quincy, MA
  • NPI 1053462358
  NPD (past)

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

{
    "created_epoch": "1171584000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1366586208",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "80 MAPLE AVE",
            "city": "SMITHTOWN",
            "state": "NY",
            "postal_code": "117873520",
            "telephone_number": "631-265-6533",
            "fax_number": "631-265-6723"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "80 MAPLE AVE",
            "city": "SMITHTOWN",
            "state": "NY",
            "postal_code": "117873520",
            "telephone_number": "631-265-6533",
            "fax_number": "631-265-6723"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HALLAIAN",
        "first_name": "KEITH",
        "name_prefix": "Dr.",
        "credential": "D.M.D., M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-16",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0106X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Pathology",
            "state": "NY",
            "license": "048248",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02325744",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Haidee Ganz-Bonhurst P.T., P.C. (Metropolitan Physical Therapy East)
• Chloe Hakanson
• Maria Halasz, LCSW
• Half Fast Medical Care PC (Prestige Medical Care)
• Taylor C Hall
• Jeanne G. Halpern-Lewis, LCSW
• Richard Halpert, M.D.
• Richard D Hamburg, MD
• Laurent G Hamlil, LPN
• Hanger Prosthetics & Orthotics East, Inc. (Hanger Prosthetics & Orthotics)

• Oral and Maxillofacial Pathology Dentistry in Smithtown, NY
• Providers in Smithtown, NY by specialty
• Oral and Maxillofacial Pathology Dentistry in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.