NPIMap

Organization Active NPI

Halvorson & Hembrough D.D.S, .M.S., PC

  • Endodontics
  • Grand Rapids, MI
National Provider Identifier
1861419640
Registry record updated Oct 5, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
EndodonticsTaxonomy code 1223E0200X
Legal business name
HALVORSON & HEMBROUGH D.D.S, .M.S., PC
Practice address
4355 Sawkaw Dr NE
Grand Rapids, MI 49525-1768
Phone
(616) 361-6609
Fax
(616) 361-6248
NPI assigned
Jul 16, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 5, 2007

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

Authorized official

Name
Ms. Katherine Klungle
Title
Office Manager
Phone
(616) 361-6609

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
EndodonticsGroup: 193400000X SINGLE SPECIALTY GROUP 1223E0200X Primary

Addresses

Primary practice location

4355 Sawkaw Dr NE
Grand Rapids, MI 49525-1768

Mailing address

4355 Sawkaw Dr NE
Grand Rapids, MI 49525-1768
Phone (616) 361-6609

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1153008000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1191542400000",
    "number": "1861419640",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4355 SAWKAW DR NE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495251768",
            "telephone_number": "616-361-6609",
            "fax_number": "616-361-6248"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4355 SAWKAW DR NE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495251768",
            "telephone_number": "616-361-6609",
            "fax_number": "616-361-6248"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HALVORSON & HEMBROUGH D.D.S, .M.S., PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-16",
        "last_updated": "2007-10-05",
        "status": "A",
        "authorized_official_last_name": "KLUNGLE",
        "authorized_official_first_name": "KATHERINE",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "616-361-6609",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Endodontics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Rapids, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2007; 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.