Individual provider Active NPI

Steven Haddad, DDS

  • Dentist
  • Hesperia, CA
National Provider Identifier
1548817455
Registry record updated Aug 26, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DDS103980 Issued in CA
Practice address
12821 Main St Ste 150
Hesperia, CA 92345-9130
Phone
(760) 947-9853
NPI assigned
Aug 26, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 26, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DDS103980 CA Primary

Addresses

Primary practice location

12821 Main St Ste 150
Hesperia, CA 92345-9130

Mailing address

24476 University Ave
Loma Linda, CA 92354-2600
Phone (909) 638-6287

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

LicenseStateTypeSpecialty
DDS103980CAMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Dental Corporation of Louis Stromberg DDS PastSince Sep 1, 2019 Accepting new patients

Interoperability endpoints

  • Direct secure messaging: shaddad1262746@direct.llu.edu

Organizations & group practices 1

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": "1566777600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1566777600000",
    "number": "1548817455",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24476 UNIVERSITY AVE",
            "city": "LOMA LINDA",
            "state": "CA",
            "postal_code": "923542600",
            "telephone_number": "909-638-6287"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12821 MAIN ST STE 150",
            "city": "HESPERIA",
            "state": "CA",
            "postal_code": "923459130",
            "telephone_number": "760-947-9853"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HADDAD",
        "first_name": "STEVEN",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-08-26",
        "last_updated": "2019-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "DDS103980",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hesperia, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2019; 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.