Provider Demographics
NPI:1790218154
Name:HALLENBECK, DAVID ALOYSIUS (DDS)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:ALOYSIUS
Last Name:HALLENBECK
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 1:138 W GREYWING CIR
Mailing Address - Street 2:
Mailing Address - City:SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:77382-1103
Mailing Address - Country:US
Mailing Address - Phone:329-789-3188
Mailing Address - Fax:
Practice Address - Street 1:25760 KUYKENDAHL RD STE A
Practice Address - Street 2:
Practice Address - City:TOMBALL
Practice Address - State:TX
Practice Address - Zip Code:77375-2733
Practice Address - Country:US
Practice Address - Phone:713-944-4199
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-04-04
Last Update Date:2020-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX334821223P0221X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program