NPIMap

Organization Active NPI

Sierra Vista Dental

  • General Practice Dentistry
  • Sierra Vista, AZ
National Provider Identifier
1316017288
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
D5877 Issued in AZ
Legal business name
SIERRA VISTA DENTAL
Practice address
4990 E. Mediterranean Dr.
Suite a
Sierra Vista, AZ 85635
Phone
(520) 459-3067
Fax
(520) 459-0113
NPI assigned
Nov 8, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Jared W Haws, D.D.S.
Title
General Dentist
Phone
(520) 459-3067

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223G0001X D5931 AZ
General Practice DentistryGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223G0001X D5877 AZ Primary
General Practice DentistryGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223G0001X D7219 AZ

Addresses

Primary practice location

4990 E. Mediterranean Dr.
Suite a
Sierra Vista, AZ 85635

Mailing address

4990 E. Mediterranean Dr.
Suite a
Sierra Vista, AZ 85635
Phone (520) 459-3067

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1162944000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1316017288",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4990 E. MEDITERRANEAN DR.",
            "address_2": "SUITE A",
            "city": "SIERRA VISTA",
            "state": "AZ",
            "postal_code": "85635",
            "telephone_number": "520-459-3067",
            "fax_number": "520-459-0113"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4990 E. MEDITERRANEAN DR.",
            "address_2": "SUITE A",
            "city": "SIERRA VISTA",
            "state": "AZ",
            "postal_code": "85635",
            "telephone_number": "520-459-3067",
            "fax_number": "520-459-0113"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SIERRA VISTA DENTAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-08",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "HAWS",
        "authorized_official_first_name": "JARED",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "GENERAL DENTIST",
        "authorized_official_telephone_number": "520-459-3067",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "AZ",
            "license": "D5931",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "AZ",
            "license": "D5877",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "AZ",
            "license": "D7219",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sierra Vista, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.