Active NPI
Adis Hasanagic, D.D.S.
- General Practice Dentistry
- St. Louis, MO
National Provider Identifier
1235496597
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 2011017058
- Practice address
- 3130 Telegraph Road
St. Louis, MO 63125-5557 - Phone
- (314) 487-8844
- Fax
- (314) 487-8529
- NPI assigned
- Apr 11, 2012
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 2011017058 | MO | Primary |
Addresses
Primary practice location
3130 Telegraph Road
St. Louis, MO 63125-5557
Mailing address
3130 Telegraph Road
St. Louis, MO 63125-5557
Phone (314) 487-8844
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1235496597 | Medicaid | MO |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2011017058 | MO | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1334102400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1771545600000",
"number": "1235496597",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3130 TELEGRAPH ROAD",
"city": "ST. LOUIS",
"state": "MO",
"postal_code": "631255557",
"telephone_number": "314-487-8844",
"fax_number": "314-487-8529"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3130 TELEGRAPH ROAD",
"city": "ST. LOUIS",
"state": "MO",
"postal_code": "631255557",
"telephone_number": "314-487-8844",
"fax_number": "314-487-8529"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HASANAGIC",
"first_name": "ADIS",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2012-04-11",
"last_updated": "2026-02-20",
"certification_date": "2026-02-20",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "MO",
"license": "2011017058",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1235496597",
"state": "MO"
}
],
"endpoints": [],
"other_names": []
}
Other providers in St. Louis, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.