Active NPI
Jonathan Haller, DDS
- Periodontics
- Falcon, CO
National Provider Identifier
1609524792
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Periodontics
- License
- DEN.00206235
- Practice address
- 7520 Bierstadt HTS Ste 125
Falcon, CO 80831-6177 - Phone
- (719) 654-0105
- NPI assigned
- Mar 16, 2022
- 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 |
|---|---|---|---|---|
| Periodontics | 1223P0300X | DEN.00206235 | CO | Primary |
Addresses
Primary practice location
7520 Bierstadt HTS Ste 125
Falcon, CO 80831-6177
Mailing address
6523 Whistle Bay Dr
Colorado Springs, CO 80923-6294
Phone (719) 641-3141
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 |
|---|---|---|---|
| DEN.00206235 | CO | MD | Periodontist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1647388800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1747872000000",
"number": "1609524792",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6523 WHISTLE BAY DR",
"city": "COLORADO SPRINGS",
"state": "CO",
"postal_code": "809236294",
"telephone_number": "719-641-3141"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7520 BIERSTADT HTS STE 125",
"city": "FALCON",
"state": "CO",
"postal_code": "808316177",
"telephone_number": "719-654-0105"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HALLER",
"first_name": "JONATHAN",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2022-03-16",
"last_updated": "2025-05-22",
"certification_date": "2025-05-22",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0300X",
"taxonomy_group": "",
"desc": "Dentist, Periodontics",
"state": "CO",
"license": "DEN.00206235",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Falcon, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.