Craig Theodore Hadgis, D.D.S.

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

License

DN18047 Issued in FL

Practice address

22 Saint Johns Medical Park Dr
Saint Augustine, FL 32086-5299

Phone

(904) 797-6453

NPI assigned

Aug 13, 2007

Last updated

Dec 19, 2022By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1186963200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1671408000000",
    "number": "1316139512",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22 SAINT JOHNS MEDICAL PARK DR",
            "city": "SAINT AUGUSTINE",
            "state": "FL",
            "postal_code": "320865299",
            "telephone_number": "904-797-6453"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22 SAINT JOHNS MEDICAL PARK DR",
            "city": "SAINT AUGUSTINE",
            "state": "FL",
            "postal_code": "320865299",
            "telephone_number": "904-797-6453"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "111 Doctors Village Dr Ste 400",
            "address_purpose": "LOCATION",
            "city": "Saint Johns",
            "state": "FL",
            "postal_code": "322592246",
            "country_code": "US",
            "telephone_number": "904-797-6453",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HADGIS",
        "first_name": "CRAIG",
        "middle_name": "THEODORE",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-08-13",
        "last_updated": "2022-12-19",
        "certification_date": "2022-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "FL",
            "license": "DN18047",
            "primary": true
        },
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "MI",
            "license": "2901019608",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• H & Z Renal Care LLC
• H2 Rehabilitation Services of Florida LLC (H2 Health)
• Brooke Nicole Haan
• David Leroy Hackney, L.M.H.C.
• Anne-Marie Haddock, LCSW
• Theodore Daniel Haeussner, D.M.D.
• Eygerdur I Hafthorsdottir, DPT
• Christina Lynn Haislip, M.S., CCC-SLP
• N Patrick Hale, MD
• Tara Haley, LMFT

• Orthodontics and Dentofacial Orthopedics Dentistry in St Augustine, FL
• Providers in St Augustine, FL by specialty
• Orthodontics and Dentofacial Orthopedics Dentistry in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2022; 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.