Kevin Patrick Hall, D.D.S.

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

DN21883 Issued in FL

Practice address

7011 Cypress Ter Ste 101
Fort Myers, FL 33907-8800

Phone

(239) 433-3075

NPI assigned

Jun 14, 2012

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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 and National Provider Directory roles.

• Dental Specialty Center of Ft. Myers, PA

  • Dentist
  • Fort Myers, FL
  • NPI 1659616993
  NPD (past)

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

{
    "created_epoch": "1339632000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1472083200000",
    "number": "1447512421",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7011 CYPRESS TER STE 101",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339078800",
            "telephone_number": "239-433-3075"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7011 CYPRESS TER STE 101",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339078800",
            "telephone_number": "239-433-3075"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HALL",
        "first_name": "KEVIN",
        "middle_name": "PATRICK",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-06-14",
        "last_updated": "2016-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IN",
            "license": "12011814A",
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "FL",
            "license": "DN21883",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Frederick Hall, PA
• Jaime Marie Realsen Hall, MD
• Janet Kay Hall, PHARMACIST
• Jonathan Hall, PHARMD
• Joshua A Hall, D.C.
• Kharyzma C Hall
• Nicole Hall
• Riley Hall
• Sarah Hall, MA BCBA
• Tamra Kay Hall, PHD, LPC, LMHC, CCS

• Oral and Maxillofacial Surgery (Dentist) in Fort Myers, FL
• Providers in Fort Myers, FL by specialty
• Oral and Maxillofacial Surgery (Dentist) in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2016; 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.