Active NPI
James Edward Haack, DDS MS
- Orthodontics and Dentofacial Orthopedics Dentistry
- Rice Lake, WI
National Provider Identifier
1316067689
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthodontics and Dentofacial Orthopedics Dentistry
- License
- 5298-015
- Practice address
- 515 N Main St
Rice Lake, WI 54868-1722 - Phone
- (715) 234-9071
- NPI assigned
- Mar 30, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthodontics and Dentofacial Orthopedics Dentistry | 1223X0400X | 5298-015 | WI | Primary |
Addresses
Primary practice location
515 N Main St
Rice Lake, WI 54868-1722
Mailing address
515 N Main St
Rice Lake, WI 54868-1722
Phone (715) 234-9071
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 075-3075055 | Other | WI | EIN |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5298-015 | WI | MD | Orthodontics and Dentofacial Orthopedic Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1175212800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1316067689",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "515 N MAIN ST",
"city": "RICE LAKE",
"state": "WI",
"postal_code": "548681722",
"telephone_number": "715-234-9071"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "515 N MAIN ST",
"city": "RICE LAKE",
"state": "WI",
"postal_code": "548681722",
"telephone_number": "715-234-9071"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HAACK",
"first_name": "JAMES",
"middle_name": "EDWARD",
"name_prefix": "Dr.",
"credential": "DDS MS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-03-30",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223X0400X",
"taxonomy_group": "",
"desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
"state": "WI",
"license": "5298-015",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "EIN",
"identifier": "075-3075055",
"state": "WI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Rice Lake, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.