RANDALL W HALLIDAY DDS INC NPI 1699082818

NPI Information

  • NPI: 1699082818
  • Provider Name: RANDALL W HALLIDAY DDS, INC
  • Classification: Dentist - 1223S0112X
  • Specialization: Oral and Maxillofacial Surgery
  • Entity Type: Organization
  • Address: 245 TERRACINA BLVD
    SUITE 211A
    REDLANDS, CA
    ZIP 92373
  • Phone: (909) 793-2629

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NPI Details

RANDALL W HALLIDAY DDS, INC is an oral and maxillofacial surgery dentist in Redlands, CA. The provider is an oral and maxillofacial surgery dentist specialized in the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region. RANDALL W HALLIDAY DDS, INC NPI is 1699082818. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

245 TERRACINA BLVD
SUITE 211A
REDLANDS, CA
ZIP 92373-852
Phone: (909) 793-2629
Fax: (909) 798-2851

The provider's authorized official is Randall W Halliday .
The authorized official title is President and has the following contact phone number (909) 793-2629.

The enumeration date for this NPI number is 9/9/2010 and was last updated on 9/9/2010.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
11223S0112XDentistOral and Maxillofacial Surgery22609CALIFORNIAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1B22609MEDICAIDCALIFORNIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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