Hale Family Dentistry Corp

Primary specialty

DentistTaxonomy code 122300000X

Legal business name

HALE FAMILY DENTISTRY CORP

Practice address

4116 E State Blvd
Fort Wayne, IN 46815-6977

Phone

(260) 482-3759

Fax

(260) 846-6641

NPI assigned

Jul 3, 2019

Organization subpart

No

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

Authorized official

Name

Cassandra Hale

Title

Manager

Phone

(260) 482-3759

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in IN

Enrollment records 1

Locations

Practitioners 3

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

• Jonathan Patrick Hale, DDS

  • General Practice Dentistry
  • Fort Wayne, IN
  • NPI 1063895670
  NPD
• Gregory Alan Crawford, DDS

  • General Practice Dentistry
  • Fort Wayne, IN
  • NPI 1194839373
  NPD (past)
• Mark F Stoner, D.D.S.

  • General Practice Dentistry
  • Fort Wayne, IN
  • NPI 1285769299
  NPD (past)

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

{
    "created_epoch": "1562112000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1682899200000",
    "number": "1912569492",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4116 E STATE BLVD",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468156977",
            "telephone_number": "260-482-3759",
            "fax_number": "260-482-3750"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4116 E STATE BLVD",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468156977",
            "telephone_number": "260-482-3759",
            "fax_number": "260-846-6641"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HALE FAMILY DENTISTRY CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-07-03",
        "last_updated": "2023-05-01",
        "certification_date": "2023-05-01",
        "status": "A",
        "authorized_official_last_name": "HALE",
        "authorized_official_first_name": "CASSANDRA",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "260-482-3759"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "332BC3200X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Customized Equipment",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "300067224",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mallory B Haji, CRNP
• Shamir Haji, M.D.
• Linda Hake
• Cathy Lou Hakes, NP
• Kathleen A Halbach, LMHC
• Cara Nicole Hale
• Cecelia E Hale, DO
• Jonathan Patrick Hale, DDS
• Angelica Haley Yelton
• Kamille Arbrintha Haley, LAC

• Dentist in Fort Wayne, IN
• Providers in Fort Wayne, IN by specialty
• Dentist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.