Michael D Hamblin, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

50263 Issued in CA

Practice address

1202 Farmers LN
Santa Rosa, CA 95405-6707

Phone

(707) 544-6280

NPI assigned

Apr 23, 2007

Last updated

Jun 26, 2021By the provider in NPPES

Sex

Male

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

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": "1177286400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624665600000",
    "number": "1831317007",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1202 FARMERS LN",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954056707",
            "telephone_number": "707-544-6280"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1202 FARMERS LN",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954056707",
            "telephone_number": "707-544-6280"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAMBLIN",
        "first_name": "MICHAEL",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-23",
        "last_updated": "2021-06-26",
        "certification_date": "2021-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "50263",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Karli Halverson
• Leanna Lynn Halvorsen
• Joshua Blaze Hamann
• Kendal Lee Hamann, M.D.
• Alex Hamberis, RAS
• Tracey Hambrick
• Paula Hamdorf
• Jennifer Hamelburg
• Terri Hamilton-Gahart, PH.D.
• Jenifer Catherine Hamilton

• General Practice Dentistry in Santa Rosa, CA
• Providers in Santa Rosa, CA by specialty
• General Practice Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2021; 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.