Healthcare Provider Details

I. General information

NPI: 1992685531
Provider Name (Legal Business Name): ROBERT S HAEGER DDS, MS, PS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/04/2025
Last Update Date: 04/23/2026
Certification Date: 04/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

24909 104TH AVE SE STE 203
KENT WA
98030-2819
US

IV. Provider business mailing address

24909 104TH AVE SE STE 203
KENT WA
98030-2819
US

V. Phone/Fax

Practice location:
  • Phone: 253-850-7043
  • Fax: 253-850-2073
Mailing address:
  • Phone: 253-850-7043
  • Fax: 253-850-2073

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License Number
License Number State

VIII. Authorized Official

Name: DR. ROBERT HAEGER
Title or Position: PRESIDENT
Credential: MS
Phone: 206-818-4339