Colleen Elizabeth Halligan, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

13057 Issued in MN

Practice address

1829 Fifth Ave South
Anoka, MN 55303

Phone

(763) 421-5320

NPI assigned

Apr 21, 2010

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

Medicare fee-for-service enrollment

Enrolled in MN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Fifth Avenue Dental, P.a.

  • General Practice Dentistry
  • Anoka, MN
  • NPI 1841229598
  NPD (past)

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

{
    "created_epoch": "1271808000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1348531200000",
    "number": "1811214588",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1829 FIFTH AVE SOUTH",
            "city": "ANOKA",
            "state": "MN",
            "postal_code": "55303",
            "telephone_number": "763-421-5320"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1829 FIFTH AVE SOUTH",
            "city": "ANOKA",
            "state": "MN",
            "postal_code": "55303",
            "telephone_number": "763-421-5320"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HALLIGAN",
        "first_name": "COLLEEN",
        "middle_name": "ELIZABETH",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-04-21",
        "last_updated": "2012-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MN",
            "license": "13057",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mariah Hackley
• Amy Marie Hagen, P.T.
• Elizabeth Anna Haider
• Williametta Augusta Hall, BS, LADC
• Sarah Elisabeth Haller, MA
• Whitney Leigh Hansen, MS-CCC-SLP
• Mark J. Harrington, D.D.S.
• Cynthia Harris, RN
• Rebeca Hartwig
• Jessica Hase

• General Practice Dentistry in Anoka, MN
• Providers in Anoka, MN by specialty
• General Practice Dentistry in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2012; 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.

Verify at the official NPI Registry.