Individual provider Active NPI

Mark V. Haley, DDS

  • General Practice Dentistry
  • Scottsdale, AZ
National Provider Identifier
1760813596
Registry record updated Dec 4, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
3467 Issued in AZ
Practice address
6345 E Bell Rd
Suite 1
Scottsdale, AZ 85254-6452
Phone
(480) 607-3600
Fax
(480) 998-9289
NPI assigned
Dec 4, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 4, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 3467 AZ Primary

Addresses

Primary practice location

6345 E Bell Rd
Suite 1
Scottsdale, AZ 85254-6452

Mailing address

6345 E Bell Rd
Suite 1
Scottsdale, AZ 85254-6452
Phone (480) 607-3600

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
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
I20150908002309 WA Order and Referring Only - DentistPractitioner - General PracticePractitioner - Dentist 2365758299

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3467AZMDPediatric Occupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Perfect Teeth - Bell Road and 64TH Street P.C. General Practice Past Accepting new patients

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": "1386115200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1386115200000",
    "number": "1760813596",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6345 E BELL RD",
            "address_2": "SUITE 1",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852546452",
            "telephone_number": "480-607-3600",
            "fax_number": "480-998-9289"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6345 E BELL RD",
            "address_2": "SUITE 1",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852546452",
            "telephone_number": "480-607-3600",
            "fax_number": "480-998-9289"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HALEY",
        "first_name": "MARK",
        "middle_name": "V.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-12-04",
        "last_updated": "2013-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AZ",
            "license": "3467",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Scottsdale, AZ

Sources for this page

Verify at the official NPI Registry.