Individual provider Active NPI

Dustin Haupt, DDS

  • Oral and Maxillofacial Surgery (Dentist)
  • Arvada, CO
National Provider Identifier
1467718809
Registry record updated Apr 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
DEN.00204240 Issued in CO
Practice address
14769 W 87TH Pkwy
Arvada, CO 80005-1454
Phone
(720) 798-1200
Fax
(720) 798-1200
NPI assigned
Apr 10, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 1, 2021

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 Surgery (Dentist) 1223S0112X DEN.00204240 CO Primary

Addresses

Primary practice location

14769 W 87TH Pkwy
Arvada, CO 80005-1454

Mailing address

14769 W 87TH Pkwy
Arvada, CO 80005-1454
Phone (720) 798-1200

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

LicenseStateTypeSpecialty
DEN.00204240COMDOral and Maxillofacial Surgery (Dentist)

Practice roles

OrganizationSpecialtyStatusNew patients
Avos Dental Specialists, PLLC Oral and Maxillofacial Surgery CurrentSince Apr 6, 2021 Accepting new patients
Board of Trustees of the University of Illinois Oral and Maxillofacial Surgery Past Accepting new patients
The Board of Trustees of the University of Illinois PastSince Jan 19, 2020 Accepting new patients

Locations

14769 W 87th Pkwy
Arvada, CO 80005
Phone (720) 798-1200

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1334016000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617235200000",
    "number": "1467718809",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14769 W 87TH PKWY",
            "city": "ARVADA",
            "state": "CO",
            "postal_code": "800051454",
            "telephone_number": "720-798-1200",
            "fax_number": "720-798-1200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14769 W 87TH PKWY",
            "city": "ARVADA",
            "state": "CO",
            "postal_code": "800051454",
            "telephone_number": "720-798-1200",
            "fax_number": "720-798-1200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAUPT",
        "first_name": "DUSTIN",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-04-10",
        "last_updated": "2021-04-01",
        "certification_date": "2021-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "CO",
            "license": "DEN.00204240",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Arvada, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2021; 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.