Active NPI
John Michael Haag, DDS
- Dentist
- Woodbury, MN
National Provider Identifier
1750485348
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 10688
- Practice address
- 2145 Woodlane Dr
Suite 104
Woodbury, MN 55125-1920 - Phone
- (651) 738-8204
- NPI assigned
- Sep 12, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 10688 | MN | Primary |
Addresses
Primary practice location
2145 Woodlane Dr
Suite 104
Woodbury, MN 55125-1920
Mailing address
2145 Woodlane Dr
Suite 104
Woodbury, MN 55125-1920
Phone (651) 738-8204
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
| License | State | Type | Specialty |
|---|---|---|---|
| 10688 | MN | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Bbccs PLLC | Past | Accepting new patients | |
| Creekview Dental PA | Dentist | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Dentist
- Woodbury, MN
- NPI 1861463465
-
- General Practice Dentistry
- Woodbury, MN
- NPI 1073327995
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1158019200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1342569600000",
"number": "1750485348",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2145 WOODLANE DR",
"address_2": "SUITE 104",
"city": "WOODBURY",
"state": "MN",
"postal_code": "551251920",
"telephone_number": "651-738-8204"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2145 WOODLANE DR",
"address_2": "SUITE 104",
"city": "WOODBURY",
"state": "MN",
"postal_code": "551251920",
"telephone_number": "651-738-8204"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HAAG",
"first_name": "JOHN",
"middle_name": "MICHAEL",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-09-12",
"last_updated": "2012-07-18",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "MN",
"license": "10688",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Woodbury, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 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.