Phillip Ha, DDS, MS

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

License

105779 Issued in CA

Practice address

1700 McHenry Ave Ste 16B
Modesto, CA 95350-4319

Phone

(209) 238-9800

NPI assigned

Aug 5, 2021

Sex

Male

Sole proprietor

No

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

Practice roles

Locations

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.

• Phillip Ha Dental Corporation

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Modesto, CA
  • NPI 1366172033
  NPD Authorized official
• Manjeet Samra, DDS, PC

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Stockton, CA
  • NPI 1952762882
  NPD (past)

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

{
    "created_epoch": "1628121600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666396800000",
    "number": "1083388813",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1700 MCHENRY AVE STE 16B",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953504319"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1700 MCHENRY AVE STE 16B",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953504319",
            "telephone_number": "209-238-9800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HA",
        "first_name": "PHILLIP",
        "name_prefix": "Dr.",
        "credential": "DDS, MS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-08-05",
        "last_updated": "2022-10-22",
        "certification_date": "2022-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "CA",
            "license": "105779",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Melissa Guzman
• Miriam Guzman
• Nicolas Guzman
• Sarina Guzman
• H. Rand Tolboe, D.P.M.
• Richard Brainard Haak, M.D.
• Elizabeth Haapala, LVN
• Brian Mitchell Haas, M.D.
• Jessica Elizabeth Haas
• Janice L Hadley, R.D.

• Orthodontics and Dentofacial Orthopedics Dentistry in Modesto, CA
• Providers in Modesto, CA by specialty
• Orthodontics and Dentofacial Orthopedics Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2022; 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.