Individual provider Active NPI

Emily Rose Chard Hallam, DMD

  • Dentist
  • Wayne, PA
National Provider Identifier
1477083277
Registry record updated Jun 14, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DS041341 Issued in PA
Practice address
744 W Lancaster Ave Ste 115
Wayne, PA 19087-2552
Phone
(610) 971-0717
NPI assigned
Jun 14, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 14, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DS041341 PA Primary

Addresses

Primary practice location

744 W Lancaster Ave Ste 115
Wayne, PA 19087-2552

Mailing address

1826 Green St Apt 2F
Philadelphia, PA 19130-3933
Phone (610) 213-8633

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
DS041341PAMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Main Line Dental Group PC Past Accepting new patients

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": "1497398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1497398400000",
    "number": "1477083277",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1826 GREEN ST APT 2F",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191303933",
            "telephone_number": "610-213-8633"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "744 W LANCASTER AVE STE 115",
            "city": "WAYNE",
            "state": "PA",
            "postal_code": "190872552",
            "telephone_number": "610-971-0717"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HALLAM",
        "first_name": "EMILY",
        "middle_name": "ROSE CHARD",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-06-14",
        "last_updated": "2017-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "PA",
            "license": "DS041341",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wayne, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2017; 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.