NPIMap

Individual provider Active NPI

John Andrew Haslam, DDS

  • General Practice Dentistry
  • Omaha, NE
National Provider Identifier
1093331076
Registry record updated Aug 31, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
7754 Issued in NE
Practice address
17110 Lakeside Hills PLZ
Omaha, NE 68130-5600
Phone
(402) 718-8737
NPI assigned
Jun 24, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 31, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X D-5140 ID
General Practice Dentistry 1223G0001X 7754 NE Primary

Addresses

Primary practice location

17110 Lakeside Hills PLZ
Omaha, NE 68130-5600

Mailing address

17110 Lakeside Hills PLZ
Omaha, NE 68130-5600
Phone (402) 718-8737

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address johnhaslam@isu.edu Direct

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
D-5140IDMDDentist
7754NEMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Hasmar Dental Co PLLC General Practice Current Accepting new patients
Crystal Clear Family Dentistry Dentist Past Accepting new patients

Organizations & group practices 2

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": "1592956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630368000000",
    "number": "1093331076",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17110 LAKESIDE HILLS PLZ",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681305600",
            "telephone_number": "402-718-8737"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17110 LAKESIDE HILLS PLZ",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681305600",
            "telephone_number": "402-718-8737"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HASLAM",
        "first_name": "JOHN",
        "middle_name": "ANDREW",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-06-24",
        "last_updated": "2021-08-31",
        "certification_date": "2021-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "ID",
            "license": "D-5140",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NE",
            "license": "7754",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "johnhaslam@isu.edu",
            "affiliation": "N",
            "endpointDescription": "Work Email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "921 S 8th Ave Stop 8088",
            "city": "Pocatello",
            "state": "ID",
            "country_code": "US",
            "postal_code": "832090002",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Omaha, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2021; 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.