Active NPI
Karen Ann Hake, DMD
- Pediatric Dentistry
- Dallas, TX
National Provider Identifier
1568552529
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Dentistry
- License
- 22961
- Practice address
- 9330 Lyndon B Johnson Fwy Ste 1060
Dallas, TX 75243-3436 - Phone
- (214) 757-4500
- Fax
- (214) 757-4501
- NPI assigned
- Oct 13, 2006
- Last updated
- Aug 19, 2020
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Pediatric Dentistry | 1223P0221X | 22961 | TX | Primary |
Addresses
Primary practice location
9330 Lyndon B Johnson Fwy Ste 1060
Dallas, TX 75243-3436
Mailing address
8380 W Cheyenne Ave
102
Las Vegas, NV 89129-8405
Phone (702) 388-8989
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 189125105 | Medicaid | TX |
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 |
|---|---|---|---|
| 22961 | TX | MD | Pediatric Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1160697600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1597795200000",
"number": "1568552529",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8380 W CHEYENNE AVE",
"address_2": "102",
"city": "LAS VEGAS",
"state": "NV",
"postal_code": "891298405",
"telephone_number": "702-388-8989",
"fax_number": "702-396-0075"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9330 LYNDON B JOHNSON FWY STE 1060",
"city": "DALLAS",
"state": "TX",
"postal_code": "752433436",
"telephone_number": "214-757-4500",
"fax_number": "214-757-4501"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HAKE",
"first_name": "KAREN",
"middle_name": "ANN",
"credential": "DMD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-10-13",
"last_updated": "2020-08-19",
"certification_date": "2020-08-19",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0221X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Dentist, Pediatric Dentistry",
"state": "TX",
"license": "22961",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "189125105",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Dallas, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.