HALE FAMILY DENTISTRY CORP (NPI# 1912569492) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1912569492 |
| Entity Type | Organization |
| Organization Name | HALE FAMILY DENTISTRY CORP |
| Practice Address |
4116 E State Blvd Fort Wayne IN 46815-6977 |
| Practice Telephone | 2604823759 |
| Practice Fax Number | 2604823750 |
| Mailing Telephone | 2604823759 |
| Mailing Fax Number | 2604823750 |
| Enumeration Date | 2019-07-03 |
| Last Update Date | 2020-10-23 |
| Authorized Official Name | CASSANDRA HALE (MANAGER) |
| Authorized Official Telephone | 2604823759 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 122300000X | Dentist | Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IN | 300003927 | 05 |
| Street Address |
4116 E STATE BLVD |
| City | FORT WAYNE |
| State | IN |
| Zip Code | 46815-6977 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194839373 | Gregory Alan Crawford | Dentist | 4116 E State Blvd, Fort Wayne, IN 46815-6911 | 2006-08-18 |
| 1063895670 | Jonathan Patrick Hale | Dentist | 4116 E State Blvd, Fort Wayne, IN 46815-6977 | 2015-06-30 |
| 1285769299 | Mark F Stoner | Dentist | 4116 E State Blvd, Fort Wayne, IN 46815-6911 | 2007-02-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306305438 | Sullivan Services, Inc. | In Home Supportive Care | 2789-b Maplecrest Rd, Fort Wayne, IN 46815 | 2019-03-18 |
| 1598250144 | Altermease Gleason | Massage Therapist | 3406 Thames Drive, Fort Wayne, IN 46815 | 2018-06-26 |
| 1881000222 | Denise Sparks | Specialist | 6415 Benham Drive, Fort Wayne, IN 46815 | 2014-07-07 |
| 1962823138 | Chad Distelrath | Physical Therapy Assistant | 1717 Maplecrest Rd, Apt 112, Fort Wayne, IN 46815 | 2013-12-13 |
| 1689943409 | Kendall Joan Labrash | Physical Therapist | 4251 Lahmeyer Rd., Fort Wayne, IN 46815 | 2011-12-22 |
| 1801179718 | Jayson Laube | Pharmacist | 6201 Stellhorn, Fort Wayne, IN 46815 | 2011-09-27 |
| 1720294432 | Muscle Therapy Clinic LLC | Massage Therapist | 6409 Georgetown North Blvd, Fort Wayne, IN 46815 | 2007-05-16 |
| 1427186436 | Legoras Conture Fashions | Prosthetic/Orthotic Supplier | 3316 Inwood Drive, Fort Wayne, IN 46815 | 2007-03-01 |
| 1932252772 | Fort Wayne Smiles PC | Dentist | 2031 Reed Road, Fort Wayne, IN 46815 | 2007-01-18 |
| 1811078538 | Timothy Doody Lynch | Dentist | 4207 Hobson Court, Fort Wayne, IN 46815 | 2006-10-18 |
| Find all providers in zip 46815 | ||||
| Taxonomy Code | 122300000X |
| Grouping | Dental Providers |
| Classification | Dentist |
| A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669025037 | Emma Kathleen O'heeney | Dentist | 9405 Illinois Rd, Fort Wayne, IN 46804-5795 | 2019-07-24 |
| 1023670874 | Cory Kappesser | Dentist | 10505 Lima Rd, Fort Wayne, IN 46818-9536 | 2019-07-02 |
| 1558843698 | John Lawrence Bixler | Dentist | 7207 Engle Rd Ste 2, Fort Wayne, IN 46804-2231 | 2018-09-05 |
| 1366960445 | Chelsea L Schafer | Dentist | 2828 E State Blvd Ste A, Fort Wayne, IN 46805-4761 | 2017-09-08 |
| 1326582925 | Mark F Stoner LLC | Dentist | 9830 Auburn Rd Suite 102, Fort Wayne, IN 46825 | 2016-12-15 |
| 1740697945 | Vishali Sharma | Dentist | 4716 Illinois Rd, Fort Wayne, IN 46804-5122 | 2014-07-20 |
| 1306250642 | Jeffrey Max Batesole | Dentist | 9121 Illinois Rd, Fort Wayne, IN 46804-5753 | 2014-06-15 |
| 1891120382 | Salkeld Family Dental, LLC | Dentist | 12962 Coldwater Rd, Fort Wayne, IN 46845-9517 | 2013-09-04 |
| 1205272168 | Tyler Jerome Kimmel | Dentist | 1717 S. Calhoun Street, Fort Wayne, IN 46802 | 2013-05-20 |
| 1467726851 | Gentle Care Family Dentistry | Dentist | 2444 Getz Rd, Fort Wayne, IN 46804-1632 | 2012-03-02 |
| Find all providers in FORT WAYNE | ||||
| City | FORT WAYNE |
| Zip Code | 46815 |
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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.