Individual provider Active NPI

Parker John Colmenares Haley, D.D.S.

  • Dentist
  • Bellingham, WA
National Provider Identifier
1053644104
Registry record updated May 1, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DE60099952 Issued in WA
Practice address
1100 Ellis St
Suite 1
Bellingham, WA 98225-5238
Phone
(360) 734-6190
Fax
(360) 733-2120
NPI assigned
Sep 8, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 1, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 59383 CA
Dentist 122300000X DE60099952 WA Primary

Addresses

Primary practice location

1100 Ellis St
Suite 1
Bellingham, WA 98225-5238

Mailing address

1100 Ellis St
Suite 1
Bellingham, WA 98225-5238
Phone (360) 734-6190

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
DE60099952WAMDDentist
59383CAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Bellingham Dental Group Dentist Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1252368000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1367366400000",
    "number": "1053644104",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 ELLIS ST",
            "address_2": "SUITE 1",
            "city": "BELLINGHAM",
            "state": "WA",
            "postal_code": "982255238",
            "telephone_number": "360-734-6190"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 ELLIS ST",
            "address_2": "SUITE 1",
            "city": "BELLINGHAM",
            "state": "WA",
            "postal_code": "982255238",
            "telephone_number": "360-734-6190",
            "fax_number": "360-733-2120"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HALEY",
        "first_name": "PARKER JOHN",
        "middle_name": "COLMENARES",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-09-08",
        "last_updated": "2013-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "59383",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WA",
            "license": "DE60099952",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bellingham, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.