Kimra L Hall, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

8336 Issued in CO

Practice address

410 Macon Ave
Canon City, CO 81212-3225

Phone

(719) 276-0117

Fax

(719) 276-0653

NPI assigned

Oct 17, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Kimra An N Lovvern Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1161043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1274659200000",
    "number": "1811078090",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "410 MACON AVE",
            "city": "CANON CITY",
            "state": "CO",
            "postal_code": "812123225",
            "telephone_number": "719-276-0117",
            "fax_number": "719-276-0653"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "410 MACON AVE",
            "city": "CANON CITY",
            "state": "CO",
            "postal_code": "812123225",
            "telephone_number": "719-276-0117",
            "fax_number": "719-276-0653"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HALL",
        "first_name": "KIMRA",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-17",
        "last_updated": "2010-05-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CO",
            "license": "8336",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "88834062",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KIMRA",
            "last_name": "LOVVERN",
            "middle_name": "AN N",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Dana Gail Guilkey, R.N., FNP-C
• Michael Ray Gummow, M.D.
• George Hafer, MA
• Jennifer Halecoulson, MA
• Emily Tighe Kayser Hall, LCSW
• Danika Hamilton
• Cornelius Hampton
• Linda Kay Hampton, LPTA
• Alessandra Hanly, HAD
• Harbor Hope Community Services

• General Practice Dentistry in Canon City, CO
• Providers in Canon City, CO by specialty
• General Practice Dentistry in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 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.