Jon Bradley Hall, D.M.D.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DN 12909 Issued in FL

Practice address

5211 S Fletcher Ave
Ste 230
Fernandina Beach, FL 32034-5370

Phone

(904) 491-8005

Fax

(904) 491-8585

NPI assigned

May 24, 2007

Last updated

Jan 10, 2017By the provider in NPPES

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

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.

• Amelia Perfect Smiles

  • Dentist
  • Fernandina Beach, FL
  • NPI 1437003258
  NPD (past)

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

{
    "created_epoch": "1179964800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1484006400000",
    "number": "1710198551",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 600577",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322600577",
            "telephone_number": "904-491-8005",
            "fax_number": "904-491-8585"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5211 S FLETCHER AVE",
            "address_2": "STE 230",
            "city": "FERNANDINA BEACH",
            "state": "FL",
            "postal_code": "320345370",
            "telephone_number": "904-491-8005",
            "fax_number": "904-491-8585"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HALL",
        "first_name": "JON",
        "middle_name": "BRADLEY",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-24",
        "last_updated": "2017-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN 12909",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Carol L Gruber, WHNP
• Gina C Guzman, MD
• H2 Rehabilitation Services of Florida LLC (H2 Health)
• Haftel Healing Arts LLC
• Jeffrey Warren Hall, LMT
• Holly L Hamilton, M.D.
• Robin C. Hampton, LMHC
• William Edward Hansberry, MD
• Patrick James Hanson
• Helen Orieanna Harding, R,CT,MR

• General Practice Dentistry in Fernandina Beach, FL
• Providers in Fernandina Beach, FL by specialty
• General Practice Dentistry in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2017; 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.