NPIMap

Organization Active NPI

Haven Orthodontics, PC

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Schuylkill Haven, PA
National Provider Identifier
1760737662
Registry record updated Jul 30, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
License
DS038055 Issued in PA
Legal business name
HAVEN ORTHODONTICS, PC
Practice address
103 E Main St
Schuylkill Haven, PA 17972-1240
Phone
(570) 385-1344
NPI assigned
Jul 17, 2012
Last updated
Jul 30, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 30, 2012

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

Authorized official

Name
Dr. Jason Michael Hartman, D.M.D., M.S.
Title
President/Orthodontist
Phone
(570) 385-1344

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X DS038055 PA Primary

Addresses

Primary practice location

103 E Main St
Schuylkill Haven, PA 17972-1240

Mailing address

103 E Main St
Schuylkill Haven, PA 17972-1240
Phone (570) 385-1344

Other identifiers 1

IdentifierTypeStateIssuer
1023923970001MedicaidPA

Other names 1

  • Pottsville Orthodontics, PC (fictitious name) Other name

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1342483200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1343606400000",
    "number": "1760737662",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "103 E MAIN ST",
            "city": "SCHUYLKILL HAVEN",
            "state": "PA",
            "postal_code": "179721240",
            "telephone_number": "570-385-1344"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "103 E MAIN ST",
            "city": "SCHUYLKILL HAVEN",
            "state": "PA",
            "postal_code": "179721240",
            "telephone_number": "570-385-1344"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HAVEN ORTHODONTICS, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-07-17",
        "last_updated": "2012-07-30",
        "status": "A",
        "authorized_official_last_name": "HARTMAN",
        "authorized_official_first_name": "JASON",
        "authorized_official_middle_name": "MICHAEL",
        "authorized_official_title_or_position": "PRESIDENT/ORTHODONTIST",
        "authorized_official_telephone_number": "570-385-1344",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.M.D., M.S."
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "PA",
            "license": "DS038055",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1023923970001",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pottsville Orthodontics, PC (fictitious name)",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Schuylkill Haven, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 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.

Verify at the official NPI Registry.