Hal L Borg, DMD

Primary specialty

DentistTaxonomy code 122300000X

License

D6735 Issued in OR

Practice address

1123 E Main St
Medford, OR 97504-7434

Phone

(541) 773-3422

Fax

(541) 779-2250

NPI assigned

Mar 16, 2007

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

Medicare fee-for-service enrollment

Enrolled in OR

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

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 and National Provider Directory roles.

• East Main Dental Center, LLP

  • General Practice Dentistry
  • Medford, OR
  • NPI 1700819596
  NPD (past)

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

{
    "created_epoch": "1174003200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1598899783",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1123 E MAIN ST",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975047434",
            "telephone_number": "541-773-3422",
            "fax_number": "541-779-2250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1123 E MAIN ST",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975047434",
            "telephone_number": "541-773-3422",
            "fax_number": "541-779-2250"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BORG",
        "first_name": "HAL",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-16",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "OR",
            "license": "D6735",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• James Booth, MD
• Mitchell Bryan Booth, DPM
• Tiana Boozer, CADC-R
• Alysse Lynette Borba, CRMII, PSS, CRGM
• Anne Meredith Bordelon
• Kristin Marie Borg
• Raven Michala Borgilt, L.M.T.
• Maribell Eduwiges Borjon
• Gemma Bornick, MD
• Hailey Ann Borovac

• Dentist in Medford, OR
• Providers in Medford, OR by specialty
• Dentist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.