Jenna Haganman

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DDS-09647 Issued in IA

Practice address

1090 Sherman Rd
Hiawatha, IA 52233

Phone

(319) 362-0043

Fax

(319) 362-9586

NPI assigned

Jun 5, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

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": "1559692800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1568073600000",
    "number": "1336707249",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1090 SHERMAN RD",
            "city": "HIAWATHA",
            "state": "IA",
            "postal_code": "52233",
            "telephone_number": "319-362-0043",
            "fax_number": "319-362-9586"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1090 SHERMAN RD",
            "city": "HIAWATHA",
            "state": "IA",
            "postal_code": "52233",
            "telephone_number": "319-362-0043",
            "fax_number": "319-362-9586"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "815 38th St SE",
            "address_purpose": "LOCATION",
            "city": "Cedar Rapids",
            "state": "IA",
            "postal_code": "524034300",
            "country_code": "US",
            "telephone_number": "319-331-5506",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HAGANMAN",
        "first_name": "JENNA",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-05",
        "last_updated": "2019-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IA",
            "license": "DDS-09647",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• General Practice Dentistry in Hiawatha, IA
• Providers in Hiawatha, IA by specialty
• General Practice Dentistry in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2019; 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.