Randall W. Halliday, D.D.S., Inc.

Primary specialty

Oral and Maxillofacial Pathology DentistryTaxonomy code 1223P0106X

License

22609 Issued in CA

Legal business name

RANDALL W. HALLIDAY, D.D.S., INC.

Practice address

1697 N Waterman Ave
San Bernardino, CA 92404-5112

Phone

(909) 886-6845

Fax

(909) 882-9804

NPI assigned

May 25, 2007

Organization subpart

No

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

Authorized official

Name

Randall Halliday, DDS

Title

President

Phone

(909) 886-6845

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1180051200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1457562993",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1697 N WATERMAN AVE",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924045112",
            "telephone_number": "909-886-6845",
            "fax_number": "909-882-9804"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1697 N WATERMAN AVE",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924045112",
            "telephone_number": "909-886-6845",
            "fax_number": "909-882-9804"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RANDALL W. HALLIDAY, D.D.S., INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-25",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "HALLIDAY",
        "authorized_official_first_name": "RANDALL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "909-886-6845",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223P0106X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Oral and Maxillofacial Pathology",
            "state": "CA",
            "license": "22609",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Krunal Rana, PT, DPT
• Naila Sabreena Rana
• Prachi Rana, MD
• Ambika Ranabhat, NP
• Randall W Halliday DDS Inc
• Tehura Randall
• Arnel Randle
• Dina Randle
• Cynthia Randles Duran
• John Franklin Randolph, M.D.

• Oral and Maxillofacial Pathology Dentistry in San Bernardino, CA
• Providers in San Bernardino, CA by specialty
• Oral and Maxillofacial Pathology Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.