Denise Vivian Halliburton, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

14397 Issued in MD

Practice address

5096 Dorsey Hall Dr Ste 106
Ellicott City, MD 21042-7711

Phone

(917) 687-0722

NPI assigned

Jul 30, 2009

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Halliburton Family Dentistry

  • General Practice Dentistry
  • Ellicott City, MD
  • NPI 1063048742
  NPD Authorized official

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

{
    "created_epoch": "1248912000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1584144000000",
    "number": "1679704290",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5096 DORSEY HALL DR STE 106",
            "city": "ELLICOTT CITY",
            "state": "MD",
            "postal_code": "210427711",
            "telephone_number": "917-687-0722"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5096 DORSEY HALL DR STE 106",
            "city": "ELLICOTT CITY",
            "state": "MD",
            "postal_code": "210427711",
            "telephone_number": "917-687-0722"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "117 Saint Patricks Dr",
            "address_purpose": "LOCATION",
            "city": "Waldorf",
            "state": "MD",
            "postal_code": "206034574",
            "country_code": "US",
            "telephone_number": "301-870-4672",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HALLIBURTON",
        "first_name": "DENISE",
        "middle_name": "VIVIAN",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-07-30",
        "last_updated": "2020-03-14",
        "certification_date": "2020-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "DC",
            "license": "DEN1000799",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MD",
            "license": "14397",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Megan Haines, MA, CAS, NCSP, PBC
• Hak J. Seok, DDS, PC (Smile Dental Care)
• Christopher Hall, LGPC
• Uzelia Josheba Hall, M.D.
• Halliburton Family Dentistry
• Constance Halligan, PH.D.
• Si Si Han, PHD, ABPP
• Sung Soon Han, PHD
• Hana Pharmacy Ellicott City (Hana Pharmacy)
• Caitlin Hancock, LCSW-C

• Dentist in Ellicott City, MD
• Providers in Ellicott City, MD by specialty
• Dentist in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2020; 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.