Individual provider Active NPI

Stephen Michael Haake, D.D.S.

  • General Practice Dentistry
  • Overland Park, KS
National Provider Identifier
1861572935
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
60089 Issued in KS
Practice address
8971 Metcalf Ave
Suite a
Overland Park, KS 66212
Phone
(913) 381-6644
NPI assigned
Oct 16, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 60089 KS Primary

Addresses

Primary practice location

8971 Metcalf Ave
Suite a
Overland Park, KS 66212

Mailing address

8971 Metcalf Ave
Suite a
Overland Park, KS 66212
Phone (913) 381-6644

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS
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
I20150605000320 KS Order and Referring Only - DentistPractitioner - Dentist 1456672278

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
60089KSMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1160956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1861572935",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8971 METCALF AVE",
            "address_2": "SUITE A",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "66212",
            "telephone_number": "913-381-6644"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8971 METCALF AVE",
            "address_2": "SUITE A",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "66212",
            "telephone_number": "913-381-6644"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAAKE",
        "first_name": "STEPHEN",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-16",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "KS",
            "license": "60089",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Overland Park, KS

Sources for this page

Verify at the official NPI Registry.