Hagan Dentistry, P.L.L.C

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DS8925 Issued in TN

Legal business name

HAGAN DENTISTRY, P.L.L.C

Practice address

3058 Fort Henry Drive
Suite a
Kingsport, TN 37664

Phone

(423) 239-8021

Fax

(423) 239-6273

NPI assigned

Nov 13, 2011

Organization subpart

No

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

Authorized official

Name

Dr. Andrew Hagan, D,M,D,NPI 1952528010

Title

President

Phone

(423) 239-8021

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Andrew Ray Hagan, DMD

  • General Practice Dentistry
  • Kingsport, TN
  • NPI 1952528010
  NPD Authorized official

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

{
    "created_epoch": "1321142400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1702512000000",
    "number": "1164709531",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3058 FORT HENRY DRIVE",
            "address_2": "SUITE A",
            "city": "KINGSPORT",
            "state": "TN",
            "postal_code": "37664",
            "telephone_number": "423-239-8021",
            "fax_number": "423-239-6273"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3058 FORT HENRY DRIVE",
            "address_2": "SUITE A",
            "city": "KINGSPORT",
            "state": "TN",
            "postal_code": "37664",
            "telephone_number": "423-239-8021",
            "fax_number": "423-239-6273"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HAGAN DENTISTRY, P.L.L.C",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-11-13",
        "last_updated": "2023-12-14",
        "certification_date": "2023-12-12",
        "status": "A",
        "authorized_official_last_name": "HAGAN",
        "authorized_official_first_name": "ANDREW",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "423-239-8021",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D,M,D,"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "TN",
            "license": "DS8925",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Daniel Kris Guinn, CRNA
• Joseph Michael Gunn, M.D.
• Rekha S Gupta, OTR
• David Allan Guy, D.D.S.
• Eric Hadley
• Andrew Ray Hagan, DMD
• Anna B Hagan, M.ED., ED.S.
• Ted W Hagen II, DMIN PHD
• Shelton Hager, M.D.
• Youngmee Hahn, CCC-SLP

• General Practice Dentistry in Kingsport, TN
• Providers in Kingsport, TN by specialty
• General Practice Dentistry in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2023; 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.