Active NPI
Michael Haddad
- General Practice Dentistry
- Napa, CA
National Provider Identifier
1992131262
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 62129
- Practice address
- 1230 Jefferson St
Napa, CA 94559-2415 - Phone
- (818) 974-7574
- NPI assigned
- Sep 18, 2013
- 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 |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 62129 | CA | Primary |
Addresses
Primary practice location
1230 Jefferson St
Napa, CA 94559-2415
Mailing address
1560 Polk St Apt B
Napa, CA 94559-2419
Phone (818) 974-7574
Medicare participation
Medicare enrollment files- 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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20150729009873 | CA | Order and Referring Only - Dentist | 9739493164 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1379462400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1694563200000",
"number": "1992131262",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1560 POLK ST APT B",
"city": "NAPA",
"state": "CA",
"postal_code": "945592419",
"telephone_number": "818-974-7574"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1230 JEFFERSON ST",
"city": "NAPA",
"state": "CA",
"postal_code": "945592415",
"telephone_number": "818-974-7574"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HADDAD",
"first_name": "MICHAEL",
"name_prefix": "Dr.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2013-09-18",
"last_updated": "2023-09-13",
"certification_date": "2023-09-13",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "CA",
"license": "62129",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Napa, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2023; 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.