Individual provider Active NPI

Christel Maria Haberland, D.D.S.

  • Oral and Maxillofacial Pathology Dentistry
  • Westerville, OH
National Provider Identifier
1396904405
Registry record updated Nov 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Pathology DentistryTaxonomy code 1223P0106X
License
30021268 Issued in OH
Practice address
477 Cooper Rd Ste 480
Westerville, OH 43081-8095
Phone
(614) 823-7135
Fax
(614) 823-7137
NPI assigned
Jun 3, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 20, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Pathology Dentistry 1223P0106X 30021268 OH Primary

Addresses

Primary practice location

477 Cooper Rd Ste 480
Westerville, OH 43081-8095

Mailing address

1810 Mackenzie Dr FL 2
Columbus, OH 43220-2967
Phone (614) 273-2250

Other identifiers 1

IdentifierTypeStateIssuer
0029887MedicaidOH

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address cooperoralpath@1047.direct.myezyaccess.com
Direct Messaging Address cooperoralpath@1047.direct.myezyaccess.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT, OH2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20130424000025 CT Practitioner - Oral SurgeryPractitioner - Pathology 5395981153 Reassigns benefits to 1 organization
I20240117003537 OH Practitioner - PathologyPractitioner - Oral and Maxillofacial PathologyPractitioner - Oral Surgery 5395981153 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
PathologyAlso: Oral Surgery
Education
Ohio State University College of Dentistry, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University Otolaryngologists IncGroup PAC ID 7719881960, 59 clinicians

Practice addresses (Care Compare)

477 Cooper Rd
Suite 480
Westerville, OH 43081-8095
Phone (614) 823-7135

Hospital & facility affiliations

  • Mount Carmel East & West Hospital, Columbus, OH, CCN 360035

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
30021268OHMDOral and Maxillofacial Pathology Dentist

Practice roles

OrganizationSpecialtyStatusNew patients
University Otolaryngologists Inc Oral and Maxillofacial Pathology CurrentSince Jan 1, 2024 Accepting new patients
Yale University CurrentSince Dec 11, 2012 Accepting new patients
Yale University CurrentSince Dec 11, 2012 Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients

Locations

800 Howard Ave
New Haven, CT 06519
Phone (203) 785-2140

300 George St
Fl 6
New Haven, CT 06511
Phone (203) 785-6610

20 York St
North Haven, CT 06510
Phone (203) 688-2433

1810 Mackenzie Dr
Fl 2
Columbus, OH 43220
Phone (614) 273-2250

2526 London Groveport Rd
Grove City, OH 43123
Phone (614) 273-2230

477 Cooper Rd
Ste 480
Westerville, OH 43081
Phone (614) 293-4238

Interoperability endpoints

  • Direct secure messaging: cooperoralpath@1047.direct.myezyaccess.com

Organizations & group practices 4

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

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1212451200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732060800000",
    "number": "1396904405",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1810 MACKENZIE DR FL 2",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432202967",
            "telephone_number": "614-273-2250",
            "fax_number": "614-273-2255"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "477 COOPER RD STE 480",
            "city": "WESTERVILLE",
            "state": "OH",
            "postal_code": "430818095",
            "telephone_number": "614-823-7135",
            "fax_number": "614-823-7137"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HABERLAND",
        "first_name": "CHRISTEL",
        "middle_name": "MARIA",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-06-03",
        "last_updated": "2024-11-20",
        "certification_date": "2024-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0106X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Pathology",
            "state": "OH",
            "license": "30021268",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0029887",
            "state": "OH"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "cooperoralpath@1047.direct.myezyaccess.com",
            "affiliation": "N",
            "address_1": "477 Cooper Rd Ste 480",
            "city": "Westerville",
            "state": "OH",
            "country_code": "US",
            "postal_code": "430818095",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "cooperoralpath@1047.direct.myezyaccess.com",
            "affiliation": "N",
            "address_1": "2526 London Groveport Rd",
            "city": "Grove City",
            "state": "OH",
            "country_code": "US",
            "postal_code": "431237685",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Westerville, OH

Sources for this page

Verify at the official NPI Registry.