Individual provider Active NPI

Daniela Haase

  • Dentist
  • Woodbury, MN
National Provider Identifier
1083090641
Registry record updated Aug 6, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
D13606 Issued in MN
Practice address
429 Commerce Dr
#400
Woodbury, MN 55125-6600
Phone
(651) 731-2342
NPI assigned
Aug 6, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 6, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X D13606 MN Primary

Addresses

Primary practice location

429 Commerce Dr
#400
Woodbury, MN 55125-6600

Mailing address

16654 Falkirk TRL
Lakeville, MN 55044-6142
Phone (563) 505-0360

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
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

Enrollment IDStateProvider typePAC IDDetails
I20160121001272 MN Order and Referring Only - Other (Physician)Practitioner - Other (Physician) 9335442508

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Northland Dental Partners, PLLC PastSince Mar 20, 2022 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": "1438819200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1438819200000",
    "number": "1083090641",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16654 FALKIRK TRL",
            "city": "LAKEVILLE",
            "state": "MN",
            "postal_code": "550446142",
            "telephone_number": "563-505-0360"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "429 COMMERCE DR",
            "address_2": "#400",
            "city": "WOODBURY",
            "state": "MN",
            "postal_code": "551256600",
            "telephone_number": "651-731-2342"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAASE",
        "first_name": "DANIELA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-08-06",
        "last_updated": "2015-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MN",
            "license": "D13606",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodbury, MN

Sources for this page

Verify at the official NPI Registry.