Provider Demographics
NPI:1275755720
Name:JASON R. HALL, D.D.S.
Entity Type:Organization
Organization Name:JASON R. HALL, D.D.S.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS COORDINATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:CHARLA
Authorized Official - Middle Name:G
Authorized Official - Last Name:ARMSTRONG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:918-481-4925
Mailing Address - Street 1:6565 S YALE AVE
Mailing Address - Street 2:SUITE 1100
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74136-8346
Mailing Address - Country:US
Mailing Address - Phone:918-481-4925
Mailing Address - Fax:918-481-4931
Practice Address - Street 1:6565 S YALE AVE
Practice Address - Street 2:SUITE 1100
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74136-8346
Practice Address - Country:US
Practice Address - Phone:918-481-4925
Practice Address - Fax:918-481-4931
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-03
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK55871223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty