Active NPI
Stephen F Haggerty, D.D.S.
- Oral and Maxillofacial Surgery (Dentist)
- Glen Rock, NJ
National Provider Identifier
1407938012
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Oral and Maxillofacial Surgery (Dentist)
- License
- 10709
- Practice address
- 361 Rock Rd
Glen Rock, NJ 07452-1842 - Phone
- (201) 445-3819
- Fax
- (201) 445-1249
- NPI assigned
- Oct 20, 2006
- 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 |
|---|---|---|---|---|
| Oral and Maxillofacial Surgery (Dentist) | 1223S0112X | 10709 | NJ | Primary |
Addresses
Primary practice location
361 Rock Rd
Glen Rock, NJ 07452-1842
Mailing address
361 Rock Rd
Glen Rock, NJ 07452-1842
Phone (201) 445-3819
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 10709 | NJ | MD | Oral and Maxillofacial Surgery (Dentist) |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161302400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1407938012",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "361 ROCK RD",
"city": "GLEN ROCK",
"state": "NJ",
"postal_code": "074521842",
"telephone_number": "201-445-3819",
"fax_number": "201-445-1249"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "361 ROCK RD",
"city": "GLEN ROCK",
"state": "NJ",
"postal_code": "074521842",
"telephone_number": "201-445-3819",
"fax_number": "201-445-1249"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HAGGERTY",
"first_name": "STEPHEN",
"middle_name": "F",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-10-20",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223S0112X",
"taxonomy_group": "",
"desc": "Dentist, Oral and Maxillofacial Surgery",
"state": "NJ",
"license": "10709",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Glen Rock, NJ
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.