John Robert Hall, D.D.S.

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

12006602 Issued in IN

Practice address

1004 Oak Drive
Richmond, IN 47374

Phone

(765) 935-1997

NPI assigned

Aug 19, 2005

Last updated

Jul 9, 2014By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Richmond Oral & Maxillofacial Surgery,LLC

  • Oral and Maxillofacial Surgery (Dentist)
  • Richmond, IN
  • NPI 1790105203
  NPD (past)
• Richmond Oral Surgery Associates, Inc.

  • Oral and Maxillofacial Surgery (Dentist)
  • Richmond, IN
  • NPI 1255411542
  NPD (past)

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

{
    "created_epoch": "1124409600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1404864000000",
    "number": "1588656128",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3063 DOGWOOD LN",
            "city": "RICHMOND",
            "state": "IN",
            "postal_code": "473743530",
            "telephone_number": "765-935-3073"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1004 OAK DRIVE",
            "city": "RICHMOND",
            "state": "IN",
            "postal_code": "47374",
            "telephone_number": "765-935-1997"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HALL",
        "first_name": "JOHN",
        "middle_name": "ROBERT",
        "name_prefix": "Mr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-19",
        "last_updated": "2014-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "IN",
            "license": "12006602",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100354300A",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM ID NUMBER",
            "identifier": "000000083630",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Melody Haist, NP
• Stacy Lynn Halcomb-Brooks, NP
• Amber Hale
• Leslie Hale, RBT
• Elsie Hall, RN
• Rachelle Christine Hall, RBT
• Gwendolyn Alice Halsted, MD
• Ashley Hamilton, RBT
• Beatrice Ann Hammaker
• Megan Alyssa Hammersla, MD

• Oral and Maxillofacial Surgery (Dentist) in Richmond, IN
• Providers in Richmond, IN by specialty
• Oral and Maxillofacial Surgery (Dentist) in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2014; 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.