George Wayne Haltom III, DDS

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

HD104468 Issued in CO

Practice address

406 S Hyland Park Drive
Suite B
Glenwood Springs, CO 81601-4274

Phone

(970) 945-9644

Fax

(970) 945-0760

NPI assigned

Oct 24, 2006

Sex

Male

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective May 31, 2016 through May 31, 2028

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: vvh_him@direct.vvh.org

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.

• Glenwood Oral Surgery, P.C.

  • Oral and Maxillofacial Surgery Clinic/Center
  • Glenwood Springs, CO
  • NPI 1043480452
  NPD (past) Authorized official
• Valley View Hospital Association

  • General Acute Care Hospital
  • Glenwood Springs, CO
  • NPI 1982668133
  NPD

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

{
    "created_epoch": "1161648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1203379200000",
    "number": "1619051968",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "406 S HYLAND PARK DRIVE",
            "address_2": "SUITE B",
            "city": "GLENWOOD SPRINGS",
            "state": "CO",
            "postal_code": "816014274",
            "telephone_number": "970-945-9644",
            "fax_number": "970-945-0760"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "406 S HYLAND PARK DRIVE",
            "address_2": "SUITE B",
            "city": "GLENWOOD SPRINGS",
            "state": "CO",
            "postal_code": "816014274",
            "telephone_number": "970-945-9644",
            "fax_number": "970-945-0760"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HALTOM",
        "first_name": "GEORGE",
        "middle_name": "WAYNE",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-24",
        "last_updated": "2008-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "CO",
            "license": "HD104468",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Patrick Hailey
• Caitlin Hall, D.O
• Cynthia Lee Hall, DO
• Teresa L Hall, CNM
• Adam Hallin, PA-C
• Hanger Prosthetics & Orthotics Inc
• Jacob Hanks
• Brenda G Hanson, NP
• Heather F Harcourt, MSW, PHD
• Stacy Hardee, PT, DPT

• All providers in Glenwood Springs, CO
• Oral and Maxillofacial Surgery (Dentist) in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2008; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.