Bruce Neil Haasken, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

8845 Issued in MN

Practice address

130 Forest Ave E
Mora, MN 55051-1510

Phone

(320) 679-1010

Fax

(320) 679-1011

NPI assigned

Jul 31, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Haasken Dental, LLC

  • Dental Clinic/Center
  • Mora, MN
  • NPI 1104435395
  NPD (past)

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

{
    "created_epoch": "1154304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1871509950",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "130 FOREST AVE E",
            "city": "MORA",
            "state": "MN",
            "postal_code": "550511510",
            "telephone_number": "320-679-1010",
            "fax_number": "320-679-1011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 FOREST AVE E",
            "city": "MORA",
            "state": "MN",
            "postal_code": "550511510",
            "telephone_number": "320-679-1010",
            "fax_number": "320-679-1011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAASKEN",
        "first_name": "BRUCE",
        "middle_name": "NEIL",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-31",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MN",
            "license": "8845",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Harlan James Gilbertson, LP
• Nicholas Gordon Giller, PHARM.D., BCPS
• Barbara Joanne Greenwood
• Kendall Leigh Gunderman
• Haasken Dental, LLC
• Bryce Wayne Haasken, DDS
• Mitchell Hager
• Gabriela L Halle, LICSW
• Matthew James Hamiel, CRNA
• Shayna Hamiel, DNP, APRN, CPNP-PC

• Dentist in Mora, MN
• Providers in Mora, MN by specialty
• Dentist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.

Verify at the official NPI Registry.