Active NPI
John Kevin Hall, DDS
- Dentist
- Stockton, CA
National Provider Identifier
1922130822
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 29054
- Practice address
- 3133 W March Lane
Suite 1080
Stockton, CA 95219-2360 - Phone
- (209) 951-4304
- Fax
- (209) 951-8910
- NPI assigned
- Mar 9, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 29054 | CA | Primary |
Addresses
Primary practice location
3133 W March Lane
Suite 1080
Stockton, CA 95219-2360
Mailing address
3133 W March Lane
Suite 1080
Stockton, CA 95219-2360
Phone (209) 951-4304
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 29054 | CA | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mora Dental Group, Inc. | Past | Accepting new patients | |
| Edith Mora DMD, Inc. | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- General Practice Dentistry
- Stockton, CA
- NPI 1245628270
-
- General Practice Dentistry
- Stockton, CA
- NPI 1093132185
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1173398400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1922130822",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3133 W MARCH LANE",
"address_2": "SUITE 1080",
"city": "STOCKTON",
"state": "CA",
"postal_code": "952192360",
"telephone_number": "209-951-4304",
"fax_number": "209-951-8910"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3133 W MARCH LANE",
"address_2": "SUITE 1080",
"city": "STOCKTON",
"state": "CA",
"postal_code": "952192360",
"telephone_number": "209-951-4304",
"fax_number": "209-951-8910"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HALL",
"first_name": "JOHN",
"middle_name": "KEVIN",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-03-09",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "CA",
"license": "29054",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Stockton, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.