Mark Allen Hall, D.D.S.
Individual provider Active NPI General Practice Dentistry · Guin, AL
NPI 1972664233 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1972664233
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Dentistry 1223G0001X
- License
- 4160 (AL)
- Practice address
- 161 12TH Ave W Ste C
Guin, AL 35563-2257 - Phone
- (205) 468-3339
- Fax
- (205) 468-3773
- NPI assigned
- Dec 12, 2006
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in AL
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160330001950 | AL | Order and Referring Only - Oral Surgery |
1850698267 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Hall Family Dentistry LLC | General Practice | Past | Accepting new patients |
| Smith Family Dentistry LLC | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 4160 | AL | Yes |
Addresses
Primary practice location
161 12TH Ave W Ste C
Guin, AL 35563-2257
Mailing address
161 12TH Ave W Ste C
P. O. Box 961
Guin, AL 35563-2257
Phone (205) 468-3339
NPI Registry JSON
{
"created_epoch": "1165881600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1972664233",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "161 12TH AVE W STE C",
"address_2": "P. O. BOX 961",
"city": "GUIN",
"state": "AL",
"postal_code": "355632257",
"telephone_number": "205-468-3339",
"fax_number": "205-468-3773"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "161 12TH AVE W STE C",
"city": "GUIN",
"state": "AL",
"postal_code": "355632257",
"telephone_number": "205-468-3339",
"fax_number": "205-468-3773"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HALL",
"first_name": "MARK",
"middle_name": "ALLEN",
"credential": "D.D.S.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-12-12",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "AL",
"license": "4160",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Guin, AL
- Makaylee Rose Carr
- Susan Cashion
- Holly Cooper
- Design Soft Consulting Corporation
- Hall Family Dentistry LLC
- Kelle May Harrison
- Lou Ann Hubbard
- Kimberly Balasky DO PC
- Lou Ann Hubbard LLC
- Dorothy W Lyons
All providers in Guin, AL · General Practice Dentistry in Alabama
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.