Active NPI
Krystal Dawn Hall, DDS
- General Practice Dentistry
- Edmond, OK
National Provider Identifier
1588077150
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 6597
- Practice address
- 21026 Highlander Ridge Dr
Edmond, OK 73012-0902 - Phone
- (405) 488-8623
- NPI assigned
- Jun 11, 2014
- Sex
- Female
- 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 | 6597 | OK | Primary |
Addresses
Primary practice location
21026 Highlander Ridge Dr
Edmond, OK 73012-0902
Mailing address
1701 Rogers Rd
Apt. 405
Fort Worth, TX 76107
Phone (405) 488-8623
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1402444800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1499212800000",
"number": "1588077150",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1701 ROGERS RD",
"address_2": "APT. 405",
"city": "FORT WORTH",
"state": "TX",
"postal_code": "76107",
"telephone_number": "405-488-8623"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "21026 HIGHLANDER RIDGE DR",
"city": "EDMOND",
"state": "OK",
"postal_code": "730120902",
"telephone_number": "405-488-8623"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HALL",
"first_name": "KRYSTAL",
"middle_name": "DAWN",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-06-11",
"last_updated": "2017-07-05",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "OK",
"license": "6597",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Edmond, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 5, 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.