Individual provider Active NPI

Brandon Conrad Hall, DDS

  • General Practice Dentistry
  • Denver, CO
National Provider Identifier
1790791853
Registry record updated Oct 18, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
9662 Issued in CO
Practice address
1590 Little Raven Street
Suite 200
Denver, CO 80202
Phone
(720) 544-1491
Fax
(720) 544-1491
NPI assigned
Jul 31, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 18, 2010

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 19027171 IL
General Practice Dentistry 1223G0001X 9662 CO Primary

Addresses

Primary practice location

1590 Little Raven Street
Suite 200
Denver, CO 80202

Mailing address

150 W. 9TH Avenue
Unit 1206
Denver, CO 80204
Phone (720) 544-1491

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
9662COMDGeneral Practice Dentistry
19027171ILMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1154304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1287360000000",
    "number": "1790791853",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "150 W. 9TH AVENUE",
            "address_2": "UNIT 1206",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "80204",
            "telephone_number": "720-544-1491"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1590 LITTLE RAVEN STREET",
            "address_2": "SUITE 200",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "80202",
            "telephone_number": "720-544-1491",
            "fax_number": "720-544-1491"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HALL",
        "first_name": "BRANDON",
        "middle_name": "CONRAD",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-31",
        "last_updated": "2010-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "19027171",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CO",
            "license": "9662",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Denver, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2010; 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.