Individual provider Active NPI

Haleigh Anne Bass, DMD

  • Dentist
  • Gastonia, NC
National Provider Identifier
1639854524
Registry record updated Feb 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
13226 Issued in NC
Practice address
1367 E Garrison Blvd Ste a
Gastonia, NC 28054-5144
Phone
(704) 864-8393
NPI assigned
Jun 19, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 13, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 13226 NC Primary

Addresses

Primary practice location

1367 E Garrison Blvd Ste a
Gastonia, NC 28054-5144

Mailing address

1367 E Garrison Blvd Ste a
Gastonia, NC 28054-5144

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230817004003 NC Order and Referring Only - DentistPractitioner - Dentist 4688036957

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
13226NCMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1687132800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707782400000",
    "number": "1639854524",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1367 E GARRISON BLVD STE A",
            "city": "GASTONIA",
            "state": "NC",
            "postal_code": "280545144"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1367 E GARRISON BLVD STE A",
            "city": "GASTONIA",
            "state": "NC",
            "postal_code": "280545144",
            "telephone_number": "704-864-8393"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BASS",
        "first_name": "HALEIGH",
        "middle_name": "ANNE",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-06-19",
        "last_updated": "2024-02-13",
        "certification_date": "2024-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NC",
            "license": "13226",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gastonia, NC

Sources for this page

Verify at the official NPI Registry.