Gordon Elwood Haag Jr., D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

27292 Issued in CA

Practice address

301 W Bastanchury Rd
Ste.#260
Fullerton, CA 92835-3419

Phone

(714) 879-4910

Fax

(714) 879-5563

NPI assigned

Apr 4, 2007

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

Medicare fee-for-service enrollment

Enrolled in CA

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

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

{
    "created_epoch": "1175644800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1326153600000",
    "number": "1215059837",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 W BASTANCHURY RD",
            "address_2": "STE.#260",
            "city": "FULLERTON",
            "state": "CA",
            "postal_code": "928353419",
            "telephone_number": "714-879-4910",
            "fax_number": "714-879-5563"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 W BASTANCHURY RD",
            "address_2": "STE.#260",
            "city": "FULLERTON",
            "state": "CA",
            "postal_code": "928353419",
            "telephone_number": "714-879-4910",
            "fax_number": "714-879-5563"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAAG",
        "first_name": "GORDON",
        "middle_name": "ELWOOD",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-04",
        "last_updated": "2012-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "27292",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lupita Guzman
• H. Abdolhosseini, D.D.S., Inc
• H. Curt Nelson DDS, a Dental Corporation
• Andrew Youngjoon Ha
• Regina B. Ha, PA-C
• Jason Michael Haakinson, PHARMD
• Arnold Ryan Haban
• Peter Habib
• Giorgio Joseph Haddad
• Kimberly Marie Hagan, PHD

• General Practice Dentistry in Fullerton, CA
• Providers in Fullerton, CA by specialty
• General Practice Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2012; 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.