Hage Dental Corporation

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

HAGE DENTAL CORPORATION

Practice address

3365 Rosecrans St Ste C
San Diego, CA 92110-4256

Phone

(619) 222-6000

Fax

(619) 923-3627

NPI assigned

Jan 30, 2020

Organization subpart

No

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

Authorized official

Name

Nicole Reid

Title

Business Manager

Phone

(619) 222-6000

Specialties & licenses 1

Addresses

Other names 1

• Smile Designers Doing business as

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Leila Khansari, D.M.D.

  • General Practice Dentistry
  • San Diego, CA
  • NPI 1649399932
  NPD (past)
• Robert W Lew, DMD

  • General Practice Dentistry
  • San Diego, CA
  • NPI 1063749844
  NPD (past)
• Reza Rafie

  • General Practice Dentistry
  • Menifee, CA
  • NPI 1588783690
  NPD (past)

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

{
    "created_epoch": "1580342400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1580342400000",
    "number": "1215568043",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3365 ROSECRANS ST STE C",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921104256",
            "telephone_number": "619-222-6000",
            "fax_number": "619-923-3627"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3365 ROSECRANS ST STE C",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921104256",
            "telephone_number": "619-222-6000",
            "fax_number": "619-923-3627"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HAGE DENTAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-01-30",
        "last_updated": "2020-01-30",
        "certification_date": "2020-01-30",
        "status": "A",
        "authorized_official_last_name": "REID",
        "authorized_official_first_name": "NICOLE",
        "authorized_official_title_or_position": "BUSINESS MANAGER",
        "authorized_official_telephone_number": "619-222-6000"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Smile Designers",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Cami Michele Hagan, BA
• Dawn C Hagan, M.D.
• Jared Hagan, O.D.
• Michael John Hagan, LMFT #131272
• Mellissa Hagberg, LCSW
• Morgan Hage
• Brittany Anne Hagedorn
• Anna Hagel, LCSW
• Hilary Hagen
• Matthew Hagen

• General Practice Dentistry in San Diego, CA
• Providers in San Diego, 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 Jan 30, 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.