Individual provider Active NPI

George Haddy, D.D.S, M.P.H

  • General Practice Dentistry
  • El Paso, TX
National Provider Identifier
1902970460
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
17718 Issued in TX
Practice address
9314 Juanchido LN
El Paso, TX 79907-6832
Phone
(915) 858-1076
Fax
(915) 858-2367
NPI assigned
Nov 17, 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 17718 TX Primary

Addresses

Primary practice location

9314 Juanchido LN
El Paso, TX 79907-6832

Mailing address

6813 Marble Canyon Dr
El Paso, TX 79912-7411
Phone (915) 587-9095

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
17718TXMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1163721600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1902970460",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6813 MARBLE CANYON DR",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799127411",
            "telephone_number": "915-587-9095",
            "fax_number": "915-858-2367"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9314 JUANCHIDO LN",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799076832",
            "telephone_number": "915-858-1076",
            "fax_number": "915-858-2367"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HADDY",
        "first_name": "GEORGE",
        "name_prefix": "Dr.",
        "credential": "D.D.S, M.P.H",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-17",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "17718",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in El Paso, TX

Sources for this page

  • 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.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.