Active NPI
Robert Allen Haake, DDS
- Dentist
- San Jose, CA
National Provider Identifier
1992728018
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 33467
- Practice address
- 3406 Royal Meadow LN
San Jose, CA 95135-1641 - Phone
- (408) 832-6995
- NPI assigned
- Jul 26, 2006
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Dentist | 122300000X | 33467 | CA | Primary |
Addresses
Primary practice location
3406 Royal Meadow LN
San Jose, CA 95135-1641
Mailing address
3406 Royal Meadow LN
San Jose, CA 95135-1641
Phone (408) 832-6995
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 |
|---|---|---|---|---|
| I20150611000599 | CA | Order and Referring Only - Oral Surgery | 4082935390 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 33467 | CA | MD | Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Rachna Pall D.D.S Inc. | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Dental Clinic/Center
- San Jose, CA
- NPI 1861981813
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153872000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1638144000000",
"number": "1992728018",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3406 ROYAL MEADOW LN",
"city": "SAN JOSE",
"state": "CA",
"postal_code": "951351641",
"telephone_number": "408-832-6995"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3406 ROYAL MEADOW LN",
"city": "SAN JOSE",
"state": "CA",
"postal_code": "951351641",
"telephone_number": "408-832-6995"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HAAKE",
"first_name": "ROBERT",
"middle_name": "ALLEN",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-07-26",
"last_updated": "2021-11-29",
"certification_date": "2021-11-29",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "CA",
"license": "33467",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Jose, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2021; 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.