Individual provider Active NPI

Reed T. Hall, DDS

  • General Practice Dentistry
  • Portland, OR
National Provider Identifier
1851516827
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
D7674 Issued in OR
Practice address
2824 NE Wasco St
Suite 210
Portland, OR 97232-1772
Phone
(503) 284-3575
Fax
(503) 284-4139
NPI assigned
Apr 16, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X D7674 OR Primary

Addresses

Primary practice location

2824 NE Wasco St
Suite 210
Portland, OR 97232-1772

Mailing address

2824 NE Wasco St
Suite 210
Portland, OR 97232-1772
Phone (503) 284-3575

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
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

Enrollment IDStateProvider typePAC IDDetails
I20151124001411 OR Order and Referring Only - DentistPractitioner - Dentist 8921308958

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
D7674ORMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Laurelwood Dental LLC General Practice Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1176681600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1851516827",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2824 NE WASCO ST",
            "address_2": "SUITE 210",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972321772",
            "telephone_number": "503-284-3575",
            "fax_number": "503-284-4139"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2824 NE WASCO ST",
            "address_2": "SUITE 210",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972321772",
            "telephone_number": "503-284-3575",
            "fax_number": "503-284-4139"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HALL",
        "first_name": "REED",
        "middle_name": "T.",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-16",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OR",
            "license": "D7674",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.