Theodore Booth Haley, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

64807 Issued in CA

Practice address

298 Grand Ave Ste 200
Oakland, CA 94610-4895

Phone

(510) 452-1068

NPI assigned

Aug 27, 2015

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1440633600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1647907200000",
    "number": "1902273782",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "298 GRAND AVE STE 200",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946104895",
            "telephone_number": "206-313-3505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "298 GRAND AVE STE 200",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946104895",
            "telephone_number": "510-452-1068"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HALEY",
        "first_name": "THEODORE",
        "middle_name": "BOOTH",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-08-27",
        "last_updated": "2022-03-22",
        "certification_date": "2022-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "64807",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "64807",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kaitlin Hale, N.P.
• Lisa Putnam Hale, R.N., P.N.P.
• Deanna Marie Haley
• Dorola Virginia Haley, FNP
• Fletcher R. Haley, B.A., B.S.
• Yagmur Halezeroglu
• Hall Dental Group Oakland
• Naeemah Hall Henderson
• Jeffrey Callan-Raymond Hall-Cottrell
• Felesia A Hall-Meeks

• Dentist in Oakland, CA
• Providers in Oakland, CA by specialty
• Dentist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2022; 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.