Mason T Haley, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

2470 Issued in ND

Practice address

103 9TH St N Ste 2
Wahpeton, ND 58075-4343

Phone

(701) 642-8566

NPI assigned

Mar 16, 2022

Last updated

Jun 15, 2022By 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

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Wahpeton Family Dentistry

  • General Practice Dentistry
  • Wahpeton, ND
  • NPI 1588365894
  NPD Authorized official
• Jeffrey S. Withuski & Paula Sabbe DDS

  • Dentist
  • Wahpeton, ND
  • NPI 1154585594
  NPD (past)

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

{
    "created_epoch": "1647388800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655251200000",
    "number": "1316695679",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "531 1ST ST N",
            "city": "WAHPETON",
            "state": "ND",
            "postal_code": "580753905",
            "telephone_number": "701-302-0670"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "103 9TH ST N STE 2",
            "city": "WAHPETON",
            "state": "ND",
            "postal_code": "580754343",
            "telephone_number": "701-642-8566"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HALEY",
        "first_name": "MASON",
        "middle_name": "T",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-03-16",
        "last_updated": "2022-06-15",
        "certification_date": "2022-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "ND",
            "license": "2470",
            "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": []
}

• Ashley Gilbertson
• Debra Jane Glander, DPT
• Lucas Bradley Glarum, PHARM.D
• Jerome Matthew Guanciale, DO
• Dorothy Haire
• Sarah Haley
• James Edward Halvorson, MD
• Emily Donna Hanson
• Kristen Hasbargen
• Mary Jane Hayes, RN, BSN, CDE

• Dentist in Wahpeton, ND
• Providers in Wahpeton, ND by specialty
• Dentist in North Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2022; 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.