Individual provider Active NPI

Haley Elizabeth Weglarz, DDS

  • General Practice Dentistry
  • Detroit, MI
National Provider Identifier
1720879117
Registry record updated Aug 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
2952000877 Issued in MI
Practice address
2700 Martin Luther King Jr Blvd
Detroit, MI 48208-2576
Phone
(313) 494-6873
Fax
(313) 494-6834
NPI assigned
May 14, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 7, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 2952000877 MI Primary
Student in an Organized Health Care Education/Training ProgramGroup: 193400000X SINGLE SPECIALTY GROUP 390200000X

Addresses

Primary practice location

2700 Martin Luther King Jr Blvd
Detroit, MI 48208-2576

Mailing address

2700 Martin Luther King Jr Blvd
Detroit, MI 48208-2576
Phone (313) 494-6873

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20250812002462 MI Order and Referring Only - DentistPractitioner - Dentist 0446758155

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2952000877MIMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1747180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754524800000",
    "number": "1720879117",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2700 MARTIN LUTHER KING JR BLVD",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482082576",
            "telephone_number": "313-494-6873",
            "fax_number": "313-494-6834"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2700 MARTIN LUTHER KING JR BLVD",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482082576",
            "telephone_number": "313-494-6873",
            "fax_number": "313-494-6834"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEGLARZ",
        "first_name": "HALEY",
        "middle_name": "ELIZABETH",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-05-14",
        "last_updated": "2025-08-07",
        "certification_date": "2025-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "2952000877",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Detroit, MI

Sources for this page

Verify at the official NPI Registry.