Active NPI
Brandon Conrad Hall, DDS
- General Practice Dentistry
- Denver, CO
National Provider Identifier
1790791853
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 9662
- 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
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 |
|---|---|---|---|---|
| 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
| License | State | Type | Specialty |
|---|---|---|---|
| 9662 | CO | MD | General Practice Dentistry |
| 19027171 | IL | MD | General 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.