NPIMap

Organization Active NPI

Hallberg Family Dentistry

  • General Practice Dentistry
  • Flagstaff, AZ
National Provider Identifier
1497376073
Registry record updated May 5, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
HALLBERG FAMILY DENTISTRY
Practice address
2222 E Cedar Ave
Flagstaff, AZ 86004-1988
Phone
(928) 774-4412
NPI assigned
May 5, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 5, 2020

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

Authorized official

Name
Dr. Dale Ronald Hallberg, DDS
Title
Dentist
Phone
(928) 774-4412

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X Primary

Addresses

Primary practice location

2222 E Cedar Ave
Flagstaff, AZ 86004-1988

Mailing address

2222 E Cedar Ave
Flagstaff, AZ 86004-1988
Phone (928) 774-4412

National Provider Directory

National Provider Directory
Tax ID family
Hallberg Family Dentistry2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

2222 E Cedar Ave
Flagstaff, AZ 86004
Phone (928) 774-4412

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1588636800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1588636800000",
    "number": "1497376073",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2222 E CEDAR AVE",
            "city": "FLAGSTAFF",
            "state": "AZ",
            "postal_code": "860041988",
            "telephone_number": "928-774-4412"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2222 E CEDAR AVE",
            "city": "FLAGSTAFF",
            "state": "AZ",
            "postal_code": "860041988",
            "telephone_number": "928-774-4412"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HALLBERG FAMILY DENTISTRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-05-05",
        "last_updated": "2020-05-05",
        "certification_date": "2020-05-05",
        "status": "A",
        "authorized_official_last_name": "HALLBERG",
        "authorized_official_first_name": "DALE",
        "authorized_official_middle_name": "RONALD",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "928-774-4412",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Flagstaff, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 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.