Active NPI
Haris Ehland, D.M.D., M.S.
- Periodontics
- Travis Afb, CA
National Provider Identifier
1932183431
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Periodontics
- License
- 4589-15
- Practice address
- 101 Bodin Cir
Travis Afb, CA 94535-1802 - Phone
- (707) 423-7008
- NPI assigned
- Nov 30, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Periodontics | 1223P0300X | 4589-15 | WI | Primary |
Addresses
Primary practice location
101 Bodin Cir
Travis Afb, CA 94535-1802
Mailing address
101 Bodin Cir
Travis Afb, CA 94535-1802
Phone (707) 423-7008
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
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4589-15 | WI | MD | Periodontist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1133308800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1608076800000",
"number": "1932183431",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "101 BODIN CIR",
"city": "TRAVIS AFB",
"state": "CA",
"postal_code": "945351802",
"telephone_number": "707-423-7008"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "101 BODIN CIR",
"city": "TRAVIS AFB",
"state": "CA",
"postal_code": "945351802",
"telephone_number": "707-423-7008"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EHLAND",
"first_name": "HARIS",
"name_prefix": "Dr.",
"credential": "D.M.D., M.S.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-11-30",
"last_updated": "2020-12-16",
"certification_date": "2020-12-16",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0300X",
"taxonomy_group": "",
"desc": "Dentist, Periodontics",
"state": "WI",
"license": "4589-15",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Travis Afb, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.