Shelly K Haas, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

30-021592 Issued in OH

Practice address

14601 Puritas Avenue
Cleveland, OH 44135

Phone

(216) 671-5452

Fax

(216) 671-5455

NPI assigned

Jul 18, 2006

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Shelly K McCarthy Other name

Medicare fee-for-service enrollment

Enrolled in OH

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• John a Hudec Puritas Dental Associates Inc

  • General Practice Dentistry
  • Cleveland, OH
  • NPI 1619909371
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1153180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1363219200000",
    "number": "1003834763",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14601 PURITAS AVENUE",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "44315",
            "telephone_number": "216-671-5452",
            "fax_number": "216-671-5455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14601 PURITAS AVENUE",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "44135",
            "telephone_number": "216-671-5452",
            "fax_number": "216-671-5455"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAAS",
        "first_name": "SHELLY",
        "middle_name": "K",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-18",
        "last_updated": "2013-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OH",
            "license": "30-021592",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2372132",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHELLY",
            "last_name": "MCCARTHY",
            "middle_name": "K",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Beverly Anne Haas
• Elizabeth Anne Haas, RBT
• Judith C Haas, MD
• Nichole Haas, LPN
• Rose Haas, LSW
• Kristen Michelle Haase, D.O.
• George Habanbo, M.D
• Carmen Mary Habat, RN
• Sharon Habat
• Ghaith Habboub, M.D.

• General Practice Dentistry in Cleveland, OH
• Providers in Cleveland, OH by specialty
• General Practice Dentistry in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.