Active NPI
David H Halliwell III, DDS DENTIST
- General Practice Dentistry
- Hattiesburg, MS
National Provider Identifier
1487850277
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 180078
- Practice address
- 314 South 25TH Avenue
Hattiesburg, MS 39401-7399 - Phone
- (601) 545-8615
- Fax
- (601) 343-8616
- NPI assigned
- Jun 27, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 180078 | MS | Primary |
Addresses
Primary practice location
314 South 25TH Avenue
Hattiesburg, MS 39401-7399
Mailing address
314 South 25TH Avenue
Hattiesburg, MS 39401-7399
Phone (601) 545-8615
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 735590 | Other | PA | UNITED CONCORDIA INSURANCE COMPANY |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 180078 | MS | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1182902400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1208908800000",
"number": "1487850277",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "314 SOUTH 25TH AVENUE",
"city": "HATTIESBURG",
"state": "MS",
"postal_code": "394017399",
"telephone_number": "601-545-8615",
"fax_number": "601-545-8616"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "314 SOUTH 25TH AVENUE",
"city": "HATTIESBURG",
"state": "MS",
"postal_code": "394017399",
"telephone_number": "601-545-8615",
"fax_number": "601-343-8616"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HALLIWELL",
"first_name": "DAVID",
"middle_name": "H",
"name_prefix": "Dr.",
"name_suffix": "III",
"credential": "DDS DENTIST",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-06-27",
"last_updated": "2008-04-23",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "MS",
"license": "180078",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITED CONCORDIA INSURANCE COMPANY",
"identifier": "735590",
"state": "PA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Hattiesburg, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.