Active NPI
Robert Michael Hales, DDS
- Pediatric Dentistry
- East Greenbush, NY
National Provider Identifier
1770974982
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Dentistry
- License
- 057698
- Practice address
- 4 Springhurst Dr
East Greenbush, NY 12061 - Phone
- (518) 373-1181
- NPI assigned
- Feb 10, 2015
- Last updated
- Dec 8, 2025
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 057698 | NY | |
| Pediatric Dentistry | 1223P0221X | 057698 | NY | Primary |
Addresses
Primary practice location
4 Springhurst Dr
East Greenbush, NY 12061
Mailing address
713 Pierce Rd
Clifton Park, NY 12065
Phone (518) 373-1181
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160604000023 | NY | Order and Referring Only - Dentist | 4183914021 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 057698 | NY | MD | Pediatric Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| McDonnell and McMahon Pediatric Dentistry PLLC | Pediatric Dentistry | Past | Accepting new patients |
Organizations & group practices 1
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.
-
dba The Smile Lodge
- Pediatric Dentistry
- Clifton Park, NY
- NPI 1821486754
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1423526400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1765152000000",
"number": "1770974982",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "713 PIERCE RD",
"city": "CLIFTON PARK",
"state": "NY",
"postal_code": "12065",
"telephone_number": "518-373-1181"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4 SPRINGHURST DR",
"city": "EAST GREENBUSH",
"state": "NY",
"postal_code": "12061",
"telephone_number": "518-373-1181"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HALES",
"first_name": "ROBERT",
"middle_name": "MICHAEL",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2015-02-10",
"last_updated": "2025-12-08",
"certification_date": "2025-12-08",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "NY",
"license": "057698",
"primary": false
},
{
"code": "1223P0221X",
"taxonomy_group": "",
"desc": "Dentist, Pediatric Dentistry",
"state": "NY",
"license": "057698",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in East Greenbush, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2025; 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.