NPIMap

Organization Active NPI

Brian R Haber DDS & Joseph a Ilacqua DDS PC

  • Oral & Maxillofacial Surgery (D.M.D.)
  • Norristown, PA
National Provider Identifier
1093732000
Registry record updated Jun 18, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral & Maxillofacial Surgery (D.M.D.)Taxonomy code 204E00000X
License
DS022706L Issued in PA
Legal business name
BRIAN R HABER DDS & JOSEPH A ILACQUA DDS PC
Practice address
2603 Dekalb Pike
Norristown, PA 19401
Phone
(610) 275-0500
Fax
(610) 275-1054
NPI assigned
Jul 16, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 18, 2008

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

Authorized official

Name
Dr. Joseph Anthony Ilacqua, DDSNPI 1396762308
Title
President Owner
Phone
(610) 275-0500

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Oral & Maxillofacial Surgery (D.M.D.)Group: 193200000X MULTI-SPECIALTY GROUP 204E00000X DS022706L PA Primary
Oral & Maxillofacial Surgery (D.M.D.)Group: 193200000X MULTI-SPECIALTY GROUP 204E00000X DS019424L PA

Addresses

Primary practice location

2603 Dekalb Pike
Norristown, PA 19401

Mailing address

2603 Dekalb Pike
Norristown, PA 19401
Phone (610) 275-0500

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1153008000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213747200000",
    "number": "1093732000",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2603 DEKALB PIKE",
            "city": "NORRISTOWN",
            "state": "PA",
            "postal_code": "19401",
            "telephone_number": "610-275-0500",
            "fax_number": "610-275-1054"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2603 DEKALB PIKE",
            "city": "NORRISTOWN",
            "state": "PA",
            "postal_code": "19401",
            "telephone_number": "610-275-0500",
            "fax_number": "610-275-1054"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRIAN R HABER DDS & JOSEPH A ILACQUA DDS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-16",
        "last_updated": "2008-06-18",
        "status": "A",
        "authorized_official_last_name": "ILACQUA",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_middle_name": "ANTHONY",
        "authorized_official_title_or_position": "PRESIDENT OWNER",
        "authorized_official_telephone_number": "610-275-0500",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "204E00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Oral & Maxillofacial Surgery",
            "state": "PA",
            "license": "DS022706L",
            "primary": true
        },
        {
            "code": "204E00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Oral & Maxillofacial Surgery",
            "state": "PA",
            "license": "DS019424L",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Norristown, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2008; 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.