HALES DENTAL PRACTICE, PC (NPI# 1790229383) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1790229383 |
| Entity Type | Organization |
| Organization Name | HALES DENTAL PRACTICE, PC |
| Other Organization Name | ANGELLIFT DENTAL CENTER |
| Practice Address |
781 Ne 7th St B Grants Pass OR 97526-1654 |
| Practice Telephone | 5414741100 |
| Practice Fax Number | 5414741103 |
| Mailing Telephone | 5414741100 |
| Mailing Fax Number | 5414741103 |
| Enumeration Date | 2016-12-15 |
| Last Update Date | 2016-12-15 |
| Authorized Official Name | DR. JIM B HALES (DENTIST/OWNER) |
| Authorized Official Telephone | 5414741100 |
| Authorized Official Credential | DDS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 305S00000X | Point of Service | D6777 | OR | Managed Care Organizations |
| Y | 261QD0000X |
Clinic/Center Specialization: Dental |
D6777 | OR | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OR | MEDICARE DME PTAN | 6080140001 | 01 |
| OR | 040241 | 05 |
| Other Name | Type Code |
|---|---|
| Angellift Dental Center | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831637537 | Hales Dental Practice, PC | Durable Medical Equipment & Medical Supplies | 781 Ne 7th St, Suite B, Grants Pass, OR 97526-1654 | 2017-02-02 |
| Street Address |
781 NE 7TH ST B |
| City | GRANTS PASS |
| State | OR |
| Zip Code | 97526-1654 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487652244 | Steven Paul Rogers | Dentist | 781 Ne 7th St, Grants Pass, OR 97526-1654 | 2005-07-14 |
| 1831637537 | Hales Dental Practice, PC | Durable Medical Equipment & Medical Supplies | 781 Ne 7th St, Suite B, Grants Pass, OR 97526-1654 | 2017-02-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205476777 | Kyla M Mccormick | Peer Specialist | 109 Nw Manzanita Avenue, Grants Pass, OR 97526 | 2020-01-13 |
| 1164076469 | Alicia Yvonne Hansen | Counselor | 1055 Clarey St., Grants Pass, OR 97526 | 2019-07-25 |
| 1841842598 | Michael Liam Reynolds, Dds, LLC | Dentist | 984 Ne 8th Street, Grants Pass Oregon, Grants Pass, OR 97526 | 2019-07-12 |
| 1881254746 | Brandi Mccrorey | Counselor | 418 Ne 6th Street, Suite 102, Grants Pass, OR 97526 | 2019-06-13 |
| 1700364502 | Premier Community Supports, LLC. | Day Training, Developmentally Disabled Services | 1439 Ne 6th St Ste C, Grants Pass, OR 97526 | 2018-08-02 |
| 1821584509 | Stefani Mcintyre | Massage Therapist | 1590 Se N Street, Warehouse #1574, Grants Pass, OR 97526 | 2018-07-06 |
| 1114467438 | Sandra P Martin | Chiropractor | 333 Sw 5th St. Suite B, Grants Pass, OR 97526 | 2017-03-06 |
| 1801347612 | Maci Wageman | Counselor | 1215 Sw G St Grants Pass Oregon 97526, Grants Pass, OR 97526 | 2016-10-17 |
| 1902353907 | Optimal Health of Southern Oregon, LLC | Family Medicine | 1600 Nw 6th St South Suite, Grants Pass, OR 97526 | 2016-09-07 |
| 1982150793 | Tanya White | Counselor | 402 Nw Fstreet, Grants Pass, OR 97526 | 2016-08-31 |
| Find all providers in zip 97526 | ||||
| Taxonomy Code | 261QD0000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Dental |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043606718 | Richard P Miller Dmd PC | Clinic/Center | 1100 Ne 7th St, Ste B, Grants Pass, OR 97526-1415 | 2015-04-09 |
| 1073872941 | Accessible Mobile Dental Hygiene LLC | Clinic/Center | 1108 Sw Ironwood Dr, Grants Pass, OR 97526-6900 | 2012-05-11 |
| 1154606853 | Accessible Mobile Dental Hygiene LLC | Clinic/Center | 4542 Averill Dr, Grants Pass, OR 97526-4114 | 2011-10-14 |
| 1356675938 | Astoria Dental Clinic | Clinic/Center | 820 Ne E Street Suite E, Grants Pass, OR 97526 | 2009-09-29 |
| 1477645794 | Rogue River Endodontics | Clinic/Center | 1004 Ramsey Ave, Grants Pass, OR 97527-5816 | 2006-09-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144834375 | Geoffrey R Clive Dds LLC | Clinic/Center | 11082 Se Oak St, Milwaukie, OR 97222-6692 | 2020-09-04 |
| 1508416041 | Columbia River Dentistry-gresham, LLC | Clinic/Center | 1700 Nw Civic Dr Ste 320, Gresham, OR 97030-3774 | 2019-09-17 |
| 1063065068 | Portland Dental Smiles | Clinic/Center | 732 Sw 3rd Ave Ste 202, Portland, OR 97204-2409 | 2019-07-18 |
| 1104478619 | David A Allen Dds | Clinic/Center | 1059 Royal Ave, Medford, OR 97504-6127 | 2019-07-15 |
| 1750933917 | Multnomah County | Clinic/Center | 11540 Ne Inverness Dr., Inverness Jail, Portland, OR 97220 | 2019-07-09 |
| 1164080875 | Central Point Dental LLC | Clinic/Center | 12338 Se 143rd Pl, Happy Valley, OR 97086-6545 | 2019-05-29 |
| 1285193003 | Hazelnut Dental LLC | Clinic/Center | 10773 Sw Beaverton-hillsdale Hwy, Ste B, Beaverton, OR 97005 | 2019-03-19 |
| 1558839498 | Kevin Prates Dds, PC | Clinic/Center | 1002 10th St Ste 1, Hood River, OR 97031-1564 | 2018-11-08 |
| 1063993749 | Roots Dental Stark LLC | Clinic/Center | 16338 Se Stark St, Portland, OR 97233-3958 | 2018-08-22 |
| 1528546330 | Christopher Brady Dmd LLC | Clinic/Center | 4707 Ne 102nd Ave Ste A, Portland, OR 97220-3393 | 2018-08-02 |
| Find all providers with the same taxonomy | ||||
| City | GRANTS PASS |
| Zip Code | 97526 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.