Bruce Haggerty Jr., D.D.S

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

0401415199 Issued in VA

Practice address

4072 Victory Blvd
Portsmouth, VA 23701-2820

Phone

(757) 337-4261

NPI assigned

Jun 23, 2013

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1371945600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1466121600000",
    "number": "1891134896",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4316 HILLINGDON BND",
            "city": "CHESAPEAKE",
            "state": "VA",
            "postal_code": "233212458",
            "telephone_number": "214-991-5166"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4072 VICTORY BLVD",
            "city": "PORTSMOUTH",
            "state": "VA",
            "postal_code": "237012820",
            "telephone_number": "757-337-4261"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAGGERTY",
        "first_name": "BRUCE",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "D.D.S",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-06-23",
        "last_updated": "2016-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TX",
            "license": "28897",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "VA",
            "license": "0401415199",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nicholas Paul Guzman, PSY.D.
• Andrew H Haber, DDS
• Billie Eckman Haddaway, O.T.R.
• Pattyalawishious Hadley, COTA
• Ashley S Hafer
• Elizabeth Louise Hain, PH.D.
• Joel Haire, PHARMD
• Jonathan L Halbach, D.O.
• Anesha Delmar Hall-Florence, PHARMD
• Benjamen Philip Hall, DO

• General Practice Dentistry in Portsmouth, VA
• Providers in Portsmouth, VA by specialty
• General Practice Dentistry in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2016; 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.