Jeffrey P. Halvorson, D.D.S, M.S.

Primary specialty

EndodonticsTaxonomy code 1223E0200X

License

13465 Issued in MI

Practice address

4355 Sawkaw Dr NE
Grand Rapids, MI 49525-1768

Phone

(616) 361-6609

Fax

(616) 361-6248

NPI assigned

Jul 21, 2006

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

Enrolled in MI

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

Credentials

Master of Science

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.

• Halvorson & Hembrough D.D.S, .M.S., PC

  • Endodontics
  • Grand Rapids, MI
  • NPI 1861419640
  NPD (past)
• Root Canal Specialists North, PLLC

  • Endodontics
  • Grand Rapids, MI
  • NPI 1316667462
  NPD (past)

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

{
    "created_epoch": "1153440000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1760403521",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4355 SAWKAW DR NE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495251768",
            "telephone_number": "616-361-6609",
            "fax_number": "616-361-6248"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4355 SAWKAW DR NE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495251768",
            "telephone_number": "616-361-6609",
            "fax_number": "616-361-6248"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HALVORSON",
        "first_name": "JEFFREY",
        "middle_name": "P.",
        "name_prefix": "Dr.",
        "credential": "D.D.S, M.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-21",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "MI",
            "license": "13465",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cornell Gray Halquist
• Thomas Scott Halstead, PH.D.
• Katie Halter, PA-C
• Judy R Halverson, LPN
• Halvorson & Hembrough D.D.S, .M.S., PC
• Erica-Jean Ham
• Hussein Jamil Hamade
• Phillip Dean Hamberg, LMFT LMSW LICENSED M
• Terence Andrew Hambleton, LMSW
• Jodi L Hamblin, M.D.

• Endodontics in Grand Rapids, MI
• Providers in Grand Rapids, MI by specialty
• Endodontics in Michigan

• 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.