Individual provider Active NPI

James P Hayden Jr., DMD

  • General Practice Dentistry
  • Salem, OR
National Provider Identifier
1770645731
Registry record updated Sep 14, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
D7149 Issued in OR
Practice address
1160 Liberty St SE
Salem, OR 97302-4143
Phone
(503) 295-1201
Fax
(503) 295-1211
NPI assigned
Dec 15, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 14, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X D7149 OR Primary

Addresses

Primary practice location

1160 Liberty St SE
Salem, OR 97302-4143

Mailing address

1160 Liberty St SE
Salem, OR 97302-4143
Phone (503) 295-1201

Other identifiers 1

IdentifierTypeStateIssuer
076773MedicaidOR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
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

Enrollment IDStateProvider typePAC IDDetails
I20160112000925 OR Order and Referring Only - DentistPractitioner - Dentist 7810299526

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1166140800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1347580800000",
    "number": "1770645731",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1160 LIBERTY ST SE",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973024143",
            "telephone_number": "503-295-1201",
            "fax_number": "503-295-1211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1160 LIBERTY ST SE",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973024143",
            "telephone_number": "503-295-1201",
            "fax_number": "503-295-1211"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAYDEN",
        "first_name": "JAMES",
        "middle_name": "P",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-15",
        "last_updated": "2012-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OR",
            "license": "D7149",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "076773",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Salem, OR

Sources for this page

Verify at the official NPI Registry.