Charles Eric Hagan, DDS

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

License

2901017100 Issued in MI

Practice address

335 W Lake Lansing Rd
East Lansing, MI 48823-1437

Phone

(517) 336-9880

Fax

(517) 336-9881

NPI assigned

May 20, 2006

Sex

Male

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

Opted out of Medicare

Yes, effective May 25, 2021 through May 25, 2027

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Hagan Rodriguez Periodontics & Implants

  • Periodontics
  • East Lansing, MI
  • NPI 1093872525
  NPD

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

{
    "created_epoch": "1148083200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675123200000",
    "number": "1619921939",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "335 W LAKE LANSING RD",
            "city": "EAST LANSING",
            "state": "MI",
            "postal_code": "488231437",
            "telephone_number": "517-336-9880",
            "fax_number": "517-336-9881"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "335 W LAKE LANSING RD",
            "city": "EAST LANSING",
            "state": "MI",
            "postal_code": "488231437",
            "telephone_number": "517-336-9880",
            "fax_number": "517-336-9881"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAGAN",
        "first_name": "CHARLES",
        "middle_name": "ERIC",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-20",
        "last_updated": "2023-01-31",
        "certification_date": "2020-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "MI",
            "license": "2901017100",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Anne Marie Haas, MSTOM, DIPL.AC
• Lianna Hadden, ATC
• Michelle M Hafner, PA
• Michael J Hafran, M.D.
• Hagan Rodriguez Periodontics & Implants
• David E Hagan, MD
• Ann M Hakkila, PHD
• Clifford Schuyler Hale, M.D.
• Sage M Hales-Ho, LMSW
• Alison L Hall, AUD

• Periodontics in East Lansing, MI
• Providers in East Lansing, MI by specialty
• Periodontics in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.