NPIMap

Organization Active NPI

Robert Haze DDS, Inc.

Doing business as Valleywide Dental

  • General Practice Dentistry
  • Palmdale, CA
National Provider Identifier
1992133318
Registry record updated Jun 9, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
35883 Issued in CA
Legal business name
ROBERT HAZE DDS, INC.
Doing business as
Valleywide Dental
Practice address
1021 W Avenue M14
Palmdale, CA 93551-1440
Phone
(661) 267-4000
Fax
(661) 267-4018
NPI assigned
Oct 22, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 9, 2014

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

Authorized official

Name
Robert Haze, DDSNPI 1972629640
Title
Owner
Phone
(661) 267-4000

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 35883 CA Primary

Addresses

Primary practice location

1021 W Avenue M14
Palmdale, CA 93551-1440

Mailing address

1021 W Avenue M14
Palmdale, CA 93551-1440
Phone (661) 267-4000

Other identifiers 2

IdentifierTypeStateIssuer
1972629640OtherCADENTI-CAL
1992133318OtherCADENTI-CAL

Other names 1

  • Valleywide Dental Doing business as

National Provider Directory

National Provider Directory

Locations

1021 W Avenue M14
Palmdale, CA 93551
Phone (661) 267-4000

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1382400000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1402272000000",
    "number": "1992133318",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1021 W AVENUE M14",
            "city": "PALMDALE",
            "state": "CA",
            "postal_code": "935511440",
            "telephone_number": "661-267-4000",
            "fax_number": "661-267-4018"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1021 W AVENUE M14",
            "city": "PALMDALE",
            "state": "CA",
            "postal_code": "935511440",
            "telephone_number": "661-267-4000",
            "fax_number": "661-267-4018"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROBERT HAZE DDS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-10-22",
        "last_updated": "2014-06-09",
        "status": "A",
        "authorized_official_last_name": "HAZE",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "661-267-4000",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "35883",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DENTI-CAL",
            "identifier": "1972629640",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DENTI-CAL",
            "identifier": "1992133318",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Valleywide Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Palmdale, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2014; 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.