MEDICARE: DAVID J. HAUSS, D.M.D., INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	31076	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1699949529
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DAVID J. HAUSS, D.M.D., INC.

Provider Business Mailing Address
First Line	:	823 ATLANTIC AVE
Second Line	:
City	:	LONG BEACH
State	:	CA
Zip	:	90813-4512
Country	:	US
Telephone Number	:	562-435-8339
Fax Number	:

Provider Business Practice Location Address
First Line	:	823 ATLANTIC AVE
Second Line	:
City	:	LONG BEACH
State	:	CA
Zip	:	90813-4512
Country	:	US
Telephone Number	:	562-435-8339
Fax Number	:

Authorized Official
Title or Position	:	DENTIST/OWNER
Name	:	DR. DAVID JONATHAN HAUSS
Credential	:	D.M.D.
Telephone Number	:	562-435-8339

Provider Enumeration Date	:	04/22/2008
Last Update Date	:	04/22/2008

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