Individual provider Active NPI

Antoine Haffar

  • General Practice Dentistry
  • Ontario, CA
National Provider Identifier
1255050803
Registry record updated Apr 15, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
107792 Issued in CA
Practice address
2850 Inland Empire Blvd Ste 100
Ontario, CA 91764-4659
Phone
(626) 506-1994
NPI assigned
Aug 25, 2022
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 15, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 107792 CA Primary

Addresses

Primary practice location

2850 Inland Empire Blvd Ste 100
Ontario, CA 91764-4659

Mailing address

2850 Inland Empire Blvd Ste 100
Ontario, CA 91764-4659
Phone (626) 506-1994

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20221109002732 CA Order and Referring Only - DentistPractitioner - Dentist 1557738242

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
107792CAMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1661385600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1776211200000",
    "number": "1255050803",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2850 INLAND EMPIRE BLVD STE 100",
            "city": "ONTARIO",
            "state": "CA",
            "postal_code": "917644659",
            "telephone_number": "626-506-1994"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2850 INLAND EMPIRE BLVD STE 100",
            "city": "ONTARIO",
            "state": "CA",
            "postal_code": "917644659",
            "telephone_number": "626-506-1994"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAFFAR",
        "first_name": "ANTOINE",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-08-25",
        "last_updated": "2026-04-15",
        "certification_date": "2026-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "107792",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ontario, CA

Sources for this page

Verify at the official NPI Registry.