Diane Edith Haberl, DDS PA

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

6108 Issued in NC

Practice address

747 Brawley School Rd
Mooresville, NC 28117

Phone

(704) 663-3001

Fax

(704) 663-6954

NPI assigned

Jun 10, 2008

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NC

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

Credentials

Physician Assistant

State licenses

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

{
    "created_epoch": "1213056000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1213056000000",
    "number": "1033379409",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "747 BRAWLEY SCHOOL RD",
            "city": "MOORESVILLE",
            "state": "NC",
            "postal_code": "28117",
            "telephone_number": "704-663-3001",
            "fax_number": "704-663-6954"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "747 BRAWLEY SCHOOL RD",
            "city": "MOORESVILLE",
            "state": "NC",
            "postal_code": "28117",
            "telephone_number": "704-663-3001",
            "fax_number": "704-663-6954"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HABERL",
        "first_name": "DIANE",
        "middle_name": "EDITH",
        "name_prefix": "Dr.",
        "credential": "DDS PA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-06-10",
        "last_updated": "2008-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NC",
            "license": "6108",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Poonam Rai Gupta, NP
• Amy Sugarman Guyer, O.D.
• Nicole Gyasi, MD
• Bandana Gyawali
• Michael M Haahs, M.D.
• Kara Hagan, PA-C
• Alexa Haggard, DPT
• Taylor Haines
• Ruth Hakobian
• Jessica Hughes Halapy, MS OTR/L

• General Practice Dentistry in Mooresville, NC
• Providers in Mooresville, NC by specialty
• General Practice Dentistry in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2008; 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.