Caitlynn Rose Haas, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

2901021553 Issued in MI

Practice address

601 Michigan Ave Ste 106
Holland, MI 49423-4951

Phone

(616) 392-3717

NPI assigned

Apr 10, 2015

Last updated

Apr 16, 2020By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 5

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Tcob Holdings, PC

  dba Mailloux Dentistry

  • General Practice Dentistry
  • Holland, MI
  • NPI 1851888481
  NPD (past)

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

{
    "created_epoch": "1428624000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1586995200000",
    "number": "1992191415",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 MICHIGAN AVE STE 106",
            "city": "HOLLAND",
            "state": "MI",
            "postal_code": "494234951",
            "telephone_number": "616-392-3717"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 MICHIGAN AVE STE 106",
            "city": "HOLLAND",
            "state": "MI",
            "postal_code": "494234951",
            "telephone_number": "616-392-3717"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2160 S. First Avenue",
            "address_2": "Bldg. 105, Suite 1814",
            "address_purpose": "LOCATION",
            "city": "Maywood",
            "state": "IL",
            "postal_code": "60153",
            "country_code": "US",
            "telephone_number": "888-584-7888",
            "fax_number": "708-216-5560",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HAAS",
        "first_name": "CAITLYNN",
        "middle_name": "ROSE",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-04-10",
        "last_updated": "2020-04-16",
        "certification_date": "2020-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019030607",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NC",
            "license": "11432",
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "IL",
            "license": "018001941",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "2901021553",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Eric Karl Gustafson, MD
• Mark Gustafson, PHARM.D.
• Leonela Guzman
• Lisa Paulukovich Ha, BEHAVIOR TECHNICIAN
• Sandi Lynn Haan, RDN,CEDS-C
• Jessica Hafner, DO
• Andrea Hagen, LMSW
• Lori Marie Hain, LMSW
• Alexis Hall
• Angela D Hall, OTR/L

• General Practice Dentistry in Holland, MI
• Providers in Holland, MI by specialty
• General Practice Dentistry in Michigan

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

Verify at the official NPI Registry.