Jesse Park Hall, D.D.S.

Primary specialty

DentistTaxonomy code 122300000X

License

6603-15 Issued in WI

Practice address

USA Dental Activity
B 2817 Reilly Road
Fort Bragg, NC 28310-7302

Phone

(910) 643-2196

NPI assigned

Aug 27, 2010

Last updated

Aug 26, 2013By 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

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

{
    "created_epoch": "1282867200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1377475200000",
    "number": "1760798730",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "USA DENTAL ACTIVITY",
            "address_2": "B 2817 REILLY ROAD",
            "city": "FORT BRAGG",
            "state": "NC",
            "postal_code": "283107302",
            "telephone_number": "910-643-2196"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "USA DENTAL ACTIVITY",
            "address_2": "B 2817 REILLY ROAD",
            "city": "FORT BRAGG",
            "state": "NC",
            "postal_code": "283107302",
            "telephone_number": "910-643-2196"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HALL",
        "first_name": "JESSE",
        "middle_name": "PARK",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-08-27",
        "last_updated": "2013-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WI",
            "license": "6603-15",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Veronica Lynn Hager, PHARMD
• Emily Lindsay Hairfield
• Alex Jonathan Hall, PA-C
• Erin Michelle Hall, PAC
• Jesse McRae Hall, PA-C
• Joshua Lee Hall, DDS
• Kaci Synclaire Hall
• Teresa I Hall, RN
• Jonathan Roberts Haller, DSC, PA-C
• Carly Halley, AUD

• Dentist in Fort Bragg, NC
• Providers in Fort Bragg, NC by specialty
• Dentist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2013; 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.