Thomas Hallquist, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

2675-015 Issued in WI

Practice address

2163 W 9TH Ave
Oshkosh, WI 54904-8043

Phone

(920) 235-6070

Fax

(920) 235-5668

NPI assigned

Jul 25, 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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in WI

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.

Enrollment records 1

Medicare enrollment (NPD)

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 and National Provider Directory roles.

• Hallquist Dental, LLC

  • Dental Clinic/Center
  • Oshkosh, WI
  • NPI 1790256428
  NPD (past) Authorized official

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

{
    "created_epoch": "1153785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1720001449",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2163 W 9TH AVE",
            "city": "OSHKOSH",
            "state": "WI",
            "postal_code": "549048043",
            "telephone_number": "920-235-6070",
            "fax_number": "920-235-5668"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2163 W 9TH AVE",
            "city": "OSHKOSH",
            "state": "WI",
            "postal_code": "549048043",
            "telephone_number": "920-235-6070",
            "fax_number": "920-235-5668"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HALLQUIST",
        "first_name": "THOMAS",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-25",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WI",
            "license": "2675-015",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "33424200",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kristoffer L Hagen, CRNA
• Susan Doris Haidlinger, RN
• Jennifer M Halbach-Giese, APNP
• Hallquist Dental, LLC
• Hallquist Family Dental LLC
• Sean P Halpin, O.D.
• Sandra L. Halron, COTA
• Julie Marie Halvorsen-Jacobs, P.T.
• Nicole L Halvorson
• Brittney Gail Hamilton, LPN

• General Practice Dentistry in Oshkosh, WI
• Providers in Oshkosh, WI by specialty
• General Practice Dentistry in Wisconsin

• 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.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.