Individual provider Active NPI

Paul M. Halgren, DDS,MSD

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Mount Vernon, WA
National Provider Identifier
1962597864
Registry record updated Nov 3, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
License
WA10060 Issued in WA
Practice address
1711 E Division St
Suite a
Mount Vernon, WA 98274-4501
Phone
(360) 336-3436
NPI assigned
Oct 4, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 3, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X WA10060 WA Primary

Addresses

Primary practice location

1711 E Division St
Suite a
Mount Vernon, WA 98274-4501

Mailing address

1711 E Division St
Suite a
Mount Vernon, WA 98274-4501
Phone (360) 336-3436

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

LicenseStateTypeSpecialty
WA10060WAMDOrthodontics and Dentofacial Orthopedic Dentist

NPI Registry JSON

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

{
    "created_epoch": "1159920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1320278400000",
    "number": "1962597864",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1711 E DIVISION ST",
            "address_2": "SUITE A",
            "city": "MOUNT VERNON",
            "state": "WA",
            "postal_code": "982744501",
            "telephone_number": "360-336-3436"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1711 E DIVISION ST",
            "address_2": "SUITE A",
            "city": "MOUNT VERNON",
            "state": "WA",
            "postal_code": "982744501",
            "telephone_number": "360-336-3436"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HALGREN",
        "first_name": "PAUL",
        "middle_name": "M.",
        "name_prefix": "Dr.",
        "credential": "DDS,MSD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-04",
        "last_updated": "2011-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "WA",
            "license": "WA10060",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Vernon, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2011; 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.