Louie Haidar

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

License

51780 Issued in CA

Practice address

12649 Poway Rd
Poway, CA 92064-4415

Phone

(858) 486-6100

Fax

(858) 486-4564

NPI assigned

Mar 19, 2007

Last updated

Dec 7, 2017By the provider in NPPES

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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Western Dental Services, Inc.

  • General Practice Dentistry
  • Poway, CA
  • NPI 1992858062
  NPD (past)

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

{
    "created_epoch": "1174262400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1512604800000",
    "number": "1114041456",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8076 DICENZA LN",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921191124",
            "telephone_number": "858-335-9390"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12649 POWAY RD",
            "city": "POWAY",
            "state": "CA",
            "postal_code": "920644415",
            "telephone_number": "858-486-6100",
            "fax_number": "858-486-4564"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAIDAR",
        "first_name": "LOUIE",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-19",
        "last_updated": "2017-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "CA",
            "license": "51780",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "D51780",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Justine Guy
• Naomu Guzman
• CHI D. Ha, M.D., FACS
• Tabitha Hageman
• Elizabeth Hahn
• Joshua Michael Harris Hall, M.D., PH.D.
• Mary Patricia Hall, PT
• Karen A Hallinan
• Tabitha Hamilton
• Kyoung Min Han, D.P.M.

• Orthodontics and Dentofacial Orthopedics Dentistry in Poway, CA
• Providers in Poway, 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 Dec 7, 2017; 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.