Individual provider Active NPI

Joshua J. Hall, DMD

  • General Practice Dentistry
  • Orlando, FL
National Provider Identifier
1417401233
Registry record updated Jul 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DN 22225 Issued in FL
Practice address
338 N Magnolia Ave Ste a
Orlando, FL 32801-1653
Phone
(407) 648-3688
NPI assigned
Aug 10, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 1, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 30.025456 OH
General Practice Dentistry 1223G0001X 10237 KY
General Practice Dentistry 1223G0001X DN 22225 FL Primary

Addresses

Primary practice location

338 N Magnolia Ave Ste a
Orlando, FL 32801-1653

Mailing address

338 N Magnolia Ave Ste a
Orlando, FL 32801-1653
Phone (407) 648-3688

Other practice location 1

595 W Fairbanks Ave
Winter Park, FL 32789-5092
Phone (407) 755-0936

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20161005000151 FL Order and Referring Only - DentistPractitioner - Dentist 6406144583

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DN 22225FLMDGeneral Practice Dentistry
10237KYMDGeneral Practice Dentistry
30.025456OHMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Legacy Smiles of Orlando General Practice CurrentSince Mar 1, 2024 Accepting new patients

Locations

338 N Magnolia Ave
Ste A
Orlando, FL 32801
Phone (407) 648-3688

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1470787200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719792000000",
    "number": "1417401233",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "338 N MAGNOLIA AVE STE A",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328011653",
            "telephone_number": "407-648-3688"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "338 N MAGNOLIA AVE STE A",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328011653",
            "telephone_number": "407-648-3688"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "595 W Fairbanks Ave",
            "address_purpose": "LOCATION",
            "city": "Winter Park",
            "state": "FL",
            "postal_code": "327895092",
            "country_code": "US",
            "telephone_number": "407-755-0936",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HALL",
        "first_name": "JOSHUA",
        "middle_name": "J.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-08-10",
        "last_updated": "2024-07-01",
        "certification_date": "2024-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OH",
            "license": "30.025456",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "KY",
            "license": "10237",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN 22225",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

Verify at the official NPI Registry.