Shadi Karam Haidar, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DN1858127 Issued in MA

Practice address

95 Washington St
Canton, MA 02021-4006

Phone

(781) 828-2600

Fax

(781) 828-2619

NPI assigned

Jul 31, 2018

Last updated

Oct 17, 2018By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1532995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1539734400000",
    "number": "1316425515",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26 DESOTO RD",
            "city": "WEST ROXBURY",
            "state": "MA",
            "postal_code": "021326033",
            "telephone_number": "617-259-7027"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "95 WASHINGTON ST",
            "city": "CANTON",
            "state": "MA",
            "postal_code": "020214006",
            "telephone_number": "781-828-2600",
            "fax_number": "781-828-2619"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "26 DeSoto Rd",
            "address_purpose": "LOCATION",
            "city": "West Roxbury",
            "state": "MA",
            "postal_code": "021326033",
            "country_code": "US",
            "telephone_number": "617-259-7027",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HAIDAR",
        "first_name": "SHADI",
        "middle_name": "KARAM",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-07-31",
        "last_updated": "2018-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MA",
            "license": "DN1858127",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jina Guimond
• Shannon Guzzino
• Ingrid Hache, OTR,L
• Paul Rynne Hagerty, L.AC
• Hadi Karam Haidar, DMD
• Sean Haley, D.O.
• Amanda Leblanc Hamm, MS, OTRL
• Hands on Health Therapeutic Services Inc
• Harmony Counseling and Wellness PC
• Jessie Harper, LMHC

• General Practice Dentistry in Canton, MA
• Providers in Canton, MA by specialty
• General Practice Dentistry in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2018; 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.