Active NPI
Peter D Hara, DMD
- Public Health Dentistry
- Desert Hot Springs, CA
National Provider Identifier
1811252505
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Public Health Dentistry
- License
- DDS100-960
- Practice address
- 11750 Cholla Dr Ste B
Desert Hot Springs, CA 92240-3066 - Phone
- (760) 251-0044
- NPI assigned
- Jul 9, 2012
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Public Health Dentistry | 1223D0001X | DDS100-960 | CA | Primary |
Addresses
Primary practice location
11750 Cholla Dr Ste B
Desert Hot Springs, CA 92240-3066
Mailing address
77490 Calle Arroba
La Quinta, CA 92253-3510
Phone (937) 475-4275
Other practice location 1
3292 Elida Rd
Lima, OH 45805-1249
Phone (419) 228-5000
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OH
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20161010001600 | OH | Order and Referring Only - Dentist | 9537457460 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DDS100-960 | CA | MD | Public Health Dentist |
Interoperability endpoints
- phara467959@direct.llu.edu
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1341792000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1594080000000",
"number": "1811252505",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "77490 CALLE ARROBA",
"city": "LA QUINTA",
"state": "CA",
"postal_code": "922533510",
"telephone_number": "937-475-4275"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11750 CHOLLA DR STE B",
"city": "DESERT HOT SPRINGS",
"state": "CA",
"postal_code": "922403066",
"telephone_number": "760-251-0044"
}
],
"practiceLocations": [
{
"address_1": "3292 Elida Rd",
"address_purpose": "LOCATION",
"city": "Lima",
"state": "OH",
"postal_code": "458051249",
"country_code": "US",
"telephone_number": "419-228-5000",
"fax_number": "419-221-3578",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "HARA",
"first_name": "PETER",
"middle_name": "D",
"name_prefix": "Dr.",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2012-07-09",
"last_updated": "2020-07-07",
"certification_date": "2020-07-07",
"status": "A"
},
"taxonomies": [
{
"code": "1223D0001X",
"taxonomy_group": "",
"desc": "Dentist, Dental Public Health",
"state": "CA",
"license": "DDS100-960",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Desert Hot Springs, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.