Provider Demographics
NPI:1669633723
Name:HALPERT DENTAL X-RAY, INC.
Entity Type:Organization
Organization Name:HALPERT DENTAL X-RAY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:H
Authorized Official - Last Name:HALPERT
Authorized Official - Suffix:
Authorized Official - Credentials:DXT
Authorized Official - Phone:818-719-0055
Mailing Address - Street 1:6342 FALLBROOK AVE STE 102
Mailing Address - Street 2:
Mailing Address - City:WOODLAND HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91367-1613
Mailing Address - Country:US
Mailing Address - Phone:818-719-0055
Mailing Address - Fax:818-592-0904
Practice Address - Street 1:6342 FALLBROOK AVE
Practice Address - Street 2:STE 102
Practice Address - City:WOODLAND HILLS
Practice Address - State:CA
Practice Address - Zip Code:91367-1613
Practice Address - Country:US
Practice Address - Phone:818-719-0055
Practice Address - Fax:818-592-0904
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-21
Last Update Date:2008-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARHP 51197292200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes292200000XLaboratoriesDental Laboratory