Cody Kent Haas, D.D.S.

Primary specialty

DentistTaxonomy code 122300000X

License

D-4156 Issued in ID

Practice address

1639 23Rd Ave
Lewiston, ID 83501-6308

Phone

(208) 746-0431

NPI assigned

Oct 2, 2009

Last updated

Oct 2, 2009By 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 2

Addresses

Medicare fee-for-service enrollment

Enrolled in ID

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

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Galen K. Haas DDS PA

  • Dentist
  • Lewiston, ID
  • NPI 1831104249
  NPD (past)

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

{
    "created_epoch": "1254441600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1254441600000",
    "number": "1114252517",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1639 23RD AVE",
            "city": "LEWISTON",
            "state": "ID",
            "postal_code": "835016308",
            "telephone_number": "208-746-0431"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1639 23RD AVE",
            "city": "LEWISTON",
            "state": "ID",
            "postal_code": "835016308",
            "telephone_number": "208-746-0431"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAAS",
        "first_name": "CODY",
        "middle_name": "KENT",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-10-02",
        "last_updated": "2009-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "ID",
            "license": "D-4156",
            "primary": true
        },
        {
            "code": "1223P0700X",
            "taxonomy_group": "",
            "desc": "Dentist, Prosthodontics",
            "state": "WA",
            "license": "DE 60023524",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brianna Michelle Guier, LMSW
• James Franklin Gump, BS, CADC
• Gretchen Gay Gundy
• Carrie Gurgel, M.ED.
• Amy Lee Guzman, LSW
• Galen Kent Haas, DDS
• Michele Haddow
• Bonita Hafer
• Kiersten M Hagle, RN
• Hair Heartbeat, LLC

• Dentist in Lewiston, ID
• Providers in Lewiston, ID by specialty
• Dentist in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.