Individual provider Active NPI

Paul D Haggan, DMD

  • Dentist
  • Somerville, NJ
National Provider Identifier
1205942489
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DI015981 Issued in NJ
Practice address
17 East High St
Somerville, NJ 08876
Phone
(908) 725-8300
Fax
(908) 725-0105
NPI assigned
Aug 21, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DI015981 NJ Primary

Addresses

Primary practice location

17 East High St
Somerville, NJ 08876

Mailing address

17 East High St
Somerville, NJ 08876
Phone (908) 725-8300

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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

Enrollment IDStateProvider typePAC IDDetails
I20150521000740 NJ Order and Referring Only - DentistPractitioner - Dentist 8820318462

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DI015981NJMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1156118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1205942489",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17 EAST HIGH ST",
            "city": "SOMERVILLE",
            "state": "NJ",
            "postal_code": "08876",
            "telephone_number": "908-725-8300",
            "fax_number": "908-725-0105"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17 EAST HIGH ST",
            "city": "SOMERVILLE",
            "state": "NJ",
            "postal_code": "08876",
            "telephone_number": "908-725-8300",
            "fax_number": "908-725-0105"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAGGAN",
        "first_name": "PAUL",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-21",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NJ",
            "license": "DI015981",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Somerville, NJ

Sources for this page

Verify at the official NPI Registry.