Provider Demographics
NPI:1760423800
Name:HALMAGHI, JOHN SALVATORE (DDS)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:SALVATORE
Last Name:HALMAGHI
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1935 N PONTIAC TRL
Mailing Address - Street 2:
Mailing Address - City:WALLED LAKE
Mailing Address - State:MI
Mailing Address - Zip Code:48390-3110
Mailing Address - Country:US
Mailing Address - Phone:248-496-4497
Mailing Address - Fax:
Practice Address - Street 1:1935 N PONTIAC TRL
Practice Address - Street 2:
Practice Address - City:WALLED LAKE
Practice Address - State:MI
Practice Address - Zip Code:48390-3110
Practice Address - Country:US
Practice Address - Phone:248-496-4497
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-09
Last Update Date:2019-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI150351223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1956372130OtherBLUE CROSS IDENTIFIER
MI1956372130OtherBLUE CROSS IDENTIFIER