Individual provider Active NPI

John George Hagigeorges, DMD

  • General Practice Dentistry
  • Bradford, MA
National Provider Identifier
1417967100
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
16268 Issued in MA
Practice address
5 South Central St
Bradford, MA 01835
Phone
(978) 372-8588
Fax
(978) 372-8780
NPI assigned
Aug 8, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 16268 MA Primary

Addresses

Primary practice location

5 South Central St
Bradford, MA 01835

Mailing address

PO Box 5265
5 South Central St
Bradford, MA 01835
Phone (978) 372-8588

Other identifiers 1

IdentifierTypeStateIssuer
X05838OtherMABLUE CROSS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160602002118 NC Order and Referring Only - DentistPractitioner - Dentist 2466742432

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
9341NCMDSpeech-Language Pathologist
16268MAMDVascular-Interventional Technology Radiologic Technologist

NPI Registry JSON

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

{
    "created_epoch": "1154995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1417967100",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5265",
            "address_2": "5 SOUTH CENTRAL ST",
            "city": "BRADFORD",
            "state": "MA",
            "postal_code": "01835",
            "telephone_number": "978-372-8588",
            "fax_number": "978-372-8780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5 SOUTH CENTRAL ST",
            "city": "BRADFORD",
            "state": "MA",
            "postal_code": "01835",
            "telephone_number": "978-372-8588",
            "fax_number": "978-372-8780"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAGIGEORGES",
        "first_name": "JOHN",
        "middle_name": "GEORGE",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-08",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MA",
            "license": "16268",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "X05838",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bradford, MA

Sources for this page

Verify at the official NPI Registry.