Gordon E Haag, Jr, DDS, Inc

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

License

272952 Issued in CA

Legal business name

GORDON E HAAG, JR, DDS, INC

Practice address

301 W Bastanchury Rd
Suite 260
Fullerton, CA 92835-3419

Phone

(714) 879-4910

Fax

(714) 879-5563

NPI assigned

Jan 10, 2012

Last updated

Jan 10, 2012By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Gordon E Haag Jr., DDSNPI 1215059837

Title

Owner

Phone

(714) 879-4910

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Gordon Elwood Haag Jr., D.D.S.

  • General Practice Dentistry
  • Fullerton, CA
  • NPI 1215059837
  Authorized official Same address or phone

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

{
    "created_epoch": "1326153600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1326153600000",
    "number": "1457621260",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 W BASTANCHURY RD",
            "address_2": "SUITE 260",
            "city": "FULLERTON",
            "state": "CA",
            "postal_code": "928353419",
            "telephone_number": "714-879-4910",
            "fax_number": "714-879-5563"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 W BASTANCHURY RD",
            "address_2": "SUITE 260",
            "city": "FULLERTON",
            "state": "CA",
            "postal_code": "928353419",
            "telephone_number": "714-879-4910",
            "fax_number": "714-879-5563"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GORDON E HAAG, JR, DDS, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-01-10",
        "last_updated": "2012-01-10",
        "status": "A",
        "authorized_official_last_name": "HAAG",
        "authorized_official_first_name": "GORDON",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "714-879-4910",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "CA",
            "license": "272952",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Samantha Goold
• Gorden Pang Dental Corporation (Fullerton Family Dentistry)
• Justin Gordillo
• Ivan Gordo Melendrez
• Gordon C Gunn MD Inc (Gunn Towbin Center)
• Gordon Gunn M.D Inc a Medical Corporation
• Gordon Lane Healthcare LLC (Gordon Lane Care Center)
• Cheyenne Eliese Gordon
• Dennis Gordon
• Julie Christine Gordon, PA-C

• Dental Clinic/Center in Fullerton, CA
• Providers in Fullerton, CA by specialty
• Dental Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2012; 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.