Mark M Hall, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

12007788 Issued in IN

Practice address

1504 Dental Dr
Bedford, IN 47421-3574

Phone

(812) 275-7975

Fax

(812) 275-7244

NPI assigned

Oct 2, 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

Medicare enrollment (NPD)

Not 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.

• Bloom Dental - Bedford, LLC

  • Dental Clinic/Center
  • Bedford, IN
  • NPI 1396653143
  NPD (past)
• Michael Meyer DMD PC

  • General Practice Dentistry
  • Bedford, IN
  • NPI 1104922129
  NPD (past)

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

{
    "created_epoch": "1159747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1679666234",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19 MEADOW MOOR WAY",
            "city": "MITCHELL",
            "state": "IN",
            "postal_code": "474461057",
            "telephone_number": "812-849-5135"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1504 DENTAL DR",
            "city": "BEDFORD",
            "state": "IN",
            "postal_code": "474213574",
            "telephone_number": "812-275-7975",
            "fax_number": "812-275-7244"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HALL",
        "first_name": "MARK",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-02",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IN",
            "license": "12007788",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elmo Allen Griggs, MD
• Rachel Gross
• Dana Lea Haddan
• Felicia Hager, RN
• Daniel Lee Hall, D.D.S.
• Stephen Richard Hammel, D.C.
• Diane Lee Michelle Hancock, CPHT
• Danielle L Harden, NP
• Grant Michael Hardisty, D.D.S.
• Wanda L. Harper, MS ED., LCAC CADACII

• General Practice Dentistry in Bedford, IN
• Providers in Bedford, IN by specialty
• General Practice Dentistry in Indiana

• 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.