NPIMap

Organization Active NPI

William J. Hagerty DDS Inc.

  • Dentist
  • Centerville, OH
National Provider Identifier
1174616932
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
30016938 Issued in OH
Legal business name
WILLIAM J. HAGERTY DDS INC.
Practice address
7058 Corporate Way
Suite #2
Centerville, OH 45459
Phone
(937) 434-3987
Fax
(937) 434-2646
NPI assigned
Oct 2, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Nevada D Endicott
Title
Business Manager
Phone
(937) 837-1888

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 30016938 OH Primary

Addresses

Primary practice location

7058 Corporate Way
Suite #2
Centerville, OH 45459

Mailing address

7058 Corporate Way
Suite #2
Centerville, OH 45459
Phone (937) 434-3987

National Provider Directory

National Provider Directory
Tax ID family
Centerville Dental Associates5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

Locations

7058 Corporate Way
Ste 2
Dayton, OH 45459
Phone (937) 434-3987

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1159747200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1174616932",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7058 CORPORATE WAY",
            "address_2": "SUITE #2",
            "city": "CENTERVILLE",
            "state": "OH",
            "postal_code": "45459",
            "telephone_number": "937-434-3987",
            "fax_number": "937-434-2646"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7058 CORPORATE WAY",
            "address_2": "SUITE #2",
            "city": "CENTERVILLE",
            "state": "OH",
            "postal_code": "45459",
            "telephone_number": "937-434-3987",
            "fax_number": "937-434-2646"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILLIAM J. HAGERTY DDS INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-02",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "ENDICOTT",
        "authorized_official_first_name": "NEVADA",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "BUSINESS MANAGER",
        "authorized_official_telephone_number": "937-837-1888"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "OH",
            "license": "30016938",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Centerville, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.