Hales Dental Practice, PC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

License

D6777 Issued in OR

Legal business name

HALES DENTAL PRACTICE, PC

Doing business as

Angellift Dental Center

Practice address

781 NE 7TH St
B
Grants Pass, OR 97526-1654

Phone

(541) 474-1100

Fax

(541) 474-1103

NPI assigned

Dec 15, 2016

Organization subpart

No

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

Authorized official

Name

Dr. Jim B Hales, DDS

Title

Dentist/Owner

Phone

(541) 474-1100

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• Angellift Dental Center Doing business as

Locations

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

{
    "created_epoch": "1481760000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1481760000000",
    "number": "1790229383",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "781 NE 7TH ST",
            "address_2": "B",
            "city": "GRANTS PASS",
            "state": "OR",
            "postal_code": "975261654",
            "telephone_number": "541-474-1100",
            "fax_number": "541-474-1103"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "781 NE 7TH ST",
            "address_2": "B",
            "city": "GRANTS PASS",
            "state": "OR",
            "postal_code": "975261654",
            "telephone_number": "541-474-1100",
            "fax_number": "541-474-1103"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HALES DENTAL PRACTICE, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-12-15",
        "last_updated": "2016-12-15",
        "status": "A",
        "authorized_official_last_name": "HALES",
        "authorized_official_first_name": "JIM",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "DENTIST/OWNER",
        "authorized_official_telephone_number": "541-474-1100",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "OR",
            "license": "D6777",
            "primary": true
        },
        {
            "code": "305S00000X",
            "taxonomy_group": "",
            "desc": "Point of Service",
            "state": "OR",
            "license": "D6777",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE DME PTAN",
            "identifier": "6080140001",
            "state": "OR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "040241",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Angellift Dental Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Erika Hageman
• Robyn Hager
• Angela Marie Hagerty, MSN, APRN, FNP-C
• Josh Haggans, AAS,CADC
• Haggen Opco North LLC (Haggen Pharmacy #2102)
• Hales Dental Practice, PC (Angellift Dental Center)
• Alexandra Hall, M.S.
• Barbara Louise Hall
• Elizabeth Renee Hall, LMT
• Emmeline Grace Hall

• Dental Clinic/Center in Grants Pass, OR
• Providers in Grants Pass, OR by specialty
• Dental Clinic/Center in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2016; 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.