Robert Haze, D.D.S

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

35883 Issued in CA

Practice address

1021 W. Ave M-14
Palmdale, CA 93535

Phone

(661) 267-4000

Fax

(661) 267-4017

NPI assigned

Mar 22, 2007

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 CA

Eligible to order & refer

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

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 and National Provider Directory roles.

• Robert Haze DDS, Inc.

  • General Practice Dentistry
  • Palmdale, CA
  • NPI 1992133318
  NPD (past) Authorized official

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

{
    "created_epoch": "1174521600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1972629640",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26873 SIERRA HWY",
            "address_2": "#502",
            "city": "SANTA CLARITA",
            "state": "CA",
            "postal_code": "913212274",
            "telephone_number": "661-267-4000",
            "fax_number": "661-267-4017"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1021 W. AVE M-14",
            "city": "PALMDALE",
            "state": "CA",
            "postal_code": "93535",
            "telephone_number": "661-267-4000",
            "fax_number": "661-267-4017"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAZE",
        "first_name": "ROBERT",
        "name_prefix": "Dr.",
        "credential": "D.D.S",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-22",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "35883",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• General Practice Dentistry in Palmdale, CA
• Providers in Palmdale, CA by specialty
• General Practice Dentistry in California

• 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.