Individual provider Active NPI

Joseph Alexander Havig, DMD

  • Dentist
  • Bossier City, LA
National Provider Identifier
1891355202
Registry record updated Jun 18, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
6997 Issued in LA
Practice address
2494 Airline Dr Ste 100
Bossier City, LA 71111-5841
Phone
(318) 317-7808
NPI assigned
Jun 18, 2019
Last updated
Jun 18, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 18, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 6997 LA Primary

Addresses

Primary practice location

2494 Airline Dr Ste 100
Bossier City, LA 71111-5841

Mailing address

40092 N Thoroughbred Way
San Tan Valley, AZ 85140-5181
Phone (480) 284-1338

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
6997LAMDCase Manager/Care Coordinator

Practice roles

OrganizationSpecialtyStatusNew patients
Agave Dental Pebble Hills PLLC Dentist Current Accepting new patients
Agave Dental Care East PLLC CurrentSince Jun 5, 2022 Accepting new patients
Nelson Nunez DMD LLC PastSince Jun 21, 2020 Accepting new patients

Locations

11680 Pebble Hills Blvd
Ste 101
El Paso, TX 79936
Phone (915) 201-2555

1806 McRae Blvd
El Paso, TX 79925
Phone (915) 591-7117

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1560816000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560816000000",
    "number": "1891355202",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "40092 N THOROUGHBRED WAY",
            "city": "SAN TAN VALLEY",
            "state": "AZ",
            "postal_code": "851405181",
            "telephone_number": "480-284-1338"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2494 AIRLINE DR STE 100",
            "city": "BOSSIER CITY",
            "state": "LA",
            "postal_code": "711115841",
            "telephone_number": "318-317-7808"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAVIG",
        "first_name": "JOSEPH",
        "middle_name": "ALEXANDER",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-06-18",
        "last_updated": "2019-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "LA",
            "license": "6997",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bossier City, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2019; 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.