Active NPI
Haiwen Zhang, DMD
- Dentist
- Santa Fe, NM
National Provider Identifier
1417516303
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- DD5662
- Practice address
- 409 Saint Michaels Dr Ste C
Santa Fe, NM 87505-7603 - Phone
- (505) 372-1121
- NPI assigned
- Jun 13, 2019
- Last updated
- Sep 26, 2023
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 0401416534 | VA | |
| Dentist | 122300000X | 9635 | SC | |
| Dentist | 122300000X | DD5662 | NM | Primary |
Addresses
Primary practice location
409 Saint Michaels Dr Ste C
Santa Fe, NM 87505-7603
Mailing address
409 Saint Michaels Dr Ste C
Santa Fe, NM 87505-7603
Phone (505) 372-1121
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DD5662 | NM | MD | Dentist |
| 9635 | SC | MD | Dentist |
| 0401416534 | VA | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Camellia Associates, LLC | Current | Accepting new patients | |
| Ronald R. Moore, D.M.D., P.a. | Past | Accepting new patients | |
| Family Dentistry of Seneca LLC | Past | Accepting new patients | |
| Michael S. Redman, D.M.D., P.C. | Past | Accepting new patients |
Locations
409 Saint Michaels Dr
Ste C
Santa Fe, NM 87505
Phone (505) 372-1121
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- General Practice Dentistry
- Espanola, NM
- NPI 1760651277
-
- General Practice Dentistry
- Seneca, SC
- NPI 1497201651
-
- General Practice Dentistry
- Seneca, SC
- NPI 1083615330
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1560384000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1695686400000",
"number": "1417516303",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "409 SAINT MICHAELS DR STE C",
"city": "SANTA FE",
"state": "NM",
"postal_code": "875057603",
"telephone_number": "505-372-1121"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "409 SAINT MICHAELS DR STE C",
"city": "SANTA FE",
"state": "NM",
"postal_code": "875057603",
"telephone_number": "505-372-1121"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ZHANG",
"first_name": "HAIWEN",
"name_prefix": "Dr.",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2019-06-13",
"last_updated": "2023-09-26",
"certification_date": "2023-09-26",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "VA",
"license": "0401416534",
"primary": false
},
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "SC",
"license": "9635",
"primary": false
},
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "NM",
"license": "DD5662",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Santa Fe, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.