NPIMap

Organization Active NPI

Hagen Dental, PC

  • General Practice Dentistry
  • Casselton, ND
National Provider Identifier
1366634016
Registry record updated Jun 30, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
2014 Issued in ND
Legal business name
HAGEN DENTAL, PC
Practice address
102 Langer Ave N
Casselton, ND 58012-3324
Phone
(701) 347-5345
Fax
(701) 347-5346
NPI assigned
Aug 16, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2014

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

Authorized official

Name
Dr. Jesse P Hagen, DDSNPI 1790865921
Title
Owner
Phone
(701) 347-5345

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 2014 ND Primary

Addresses

Primary practice location

102 Langer Ave N
Casselton, ND 58012-3324

Mailing address

PO Box 520
Casselton, ND 58012-0520
Phone (701) 347-5345

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

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

NPI Registry JSON

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

{
    "created_epoch": "1187222400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1404086400000",
    "number": "1366634016",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 520",
            "city": "CASSELTON",
            "state": "ND",
            "postal_code": "580120520",
            "telephone_number": "701-347-5345",
            "fax_number": "701-347-5346"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 LANGER AVE N",
            "city": "CASSELTON",
            "state": "ND",
            "postal_code": "580123324",
            "telephone_number": "701-347-5345",
            "fax_number": "701-347-5346"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HAGEN DENTAL, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-16",
        "last_updated": "2014-06-30",
        "status": "A",
        "authorized_official_last_name": "HAGEN",
        "authorized_official_first_name": "JESSE",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "701-347-5345",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "ND",
            "license": "2014",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Casselton, ND

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2014; 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.