Brenda Jean Hall, DDS, MD

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

DN013820 Issued in GA

Practice address

1463 Klondike Rd SW
Suite C
Conyers, GA 30094-5127

Phone

(770) 483-9692

NPI assigned

Feb 14, 2008

Sex

Female

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)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Oral Surgery Associates & Dental Implant Center PC

  • Oral and Maxillofacial Surgery (Dentist)
  • Conyers, GA
  • NPI 1003924788
  NPD (past)
• Sentry Anesthesia Management, LLC

  • Anesthesiology Physician
  • Newnan, GA
  • NPI 1134544794
  NPD (past)

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

{
    "created_epoch": "1202947200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1287619200000",
    "number": "1942478755",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2208 ZERMATT CT SE",
            "city": "SMYRNA",
            "state": "GA",
            "postal_code": "300806566",
            "telephone_number": "404-216-1981"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1463 KLONDIKE RD SW",
            "address_2": "SUITE C",
            "city": "CONYERS",
            "state": "GA",
            "postal_code": "300945127",
            "telephone_number": "770-483-9692"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HALL",
        "first_name": "BRENDA",
        "middle_name": "JEAN",
        "name_prefix": "Dr.",
        "credential": "DDS, MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-02-14",
        "last_updated": "2010-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "OK",
            "license": "5654",
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "GA",
            "license": "DN013820",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sadik N Haba, M.D.
• Erica Janeen Haber, PA-C
• Hagan Ziegler and Associates PC
• Linda Bailey Hagan, LCSW
• Nikki Halipilias
• Cindy W Hall
• Lauren Hall
• Tiffany Hall, LPC
• Maria Halpin, LPC
• Heath W Hampton, MD

• Oral and Maxillofacial Surgery (Dentist) in Conyers, GA
• Providers in Conyers, GA by specialty
• Oral and Maxillofacial Surgery (Dentist) in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2010; 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.