Mark James Hagele, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

39410 Issued in CA

Practice address

101 Providence Mine Rd
Suite 103-B
Nevada City, CA 95959-2939

Phone

(530) 265-6656

NPI assigned

Oct 10, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Green means eligible to order or refer.

Enrollment records 1

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 and National Provider Directory roles.

• Mark J. Hagele, DDS, Inc.

  • Dentist
  • Nevada City, CA
  • NPI 1912184409
  NPD (past) Authorized official

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

{
    "created_epoch": "1160438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1382486400000",
    "number": "1124116660",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 PROVIDENCE MINE RD",
            "address_2": "SUITE 103-B",
            "city": "NEVADA CITY",
            "state": "CA",
            "postal_code": "959592939",
            "telephone_number": "530-265-6656"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 PROVIDENCE MINE RD",
            "address_2": "SUITE 103-B",
            "city": "NEVADA CITY",
            "state": "CA",
            "postal_code": "959592939",
            "telephone_number": "530-265-6656"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAGELE",
        "first_name": "MARK",
        "middle_name": "JAMES",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-10",
        "last_updated": "2013-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "39410",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DENTI-CAL",
            "identifier": "D39410",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Melissa Elizabeth Grey
• Linda Parenzan Grotke, MS
• Growing Home Counseling
• Growing Home Counseling
• Melissa A Guevara
• Ellen Grace Hair, APCC, NCC
• Stephen Eric Halverson, CHIROPRACTOR
• Carson Christopher Ham, PH.D.
• Jessica Hambley, DC
• Patricia Ann Hamilton

• General Practice Dentistry in Nevada City, CA
• Providers in Nevada City, CA by specialty
• General Practice Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2013; 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.

Verify at the official NPI Registry.