Individual provider Active NPI

Karen Ann Hake, DMD

  • Pediatric Dentistry
  • Dallas, TX
National Provider Identifier
1568552529
Registry record updated Aug 19, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
22961 Issued in TX
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, 2020By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 19, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 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

IdentifierTypeStateIssuer
189125105MedicaidTX

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

LicenseStateTypeSpecialty
22961TXMDPediatric 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.

Verify at the official NPI Registry.