Individual provider Active NPI

M. Johnson Hagood, D.D.S.

  • General Practice Dentistry
  • Vero Beach, FL
National Provider Identifier
1639295363
Registry record updated Aug 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DN15668 Issued in FL
Practice address
886 Dahlia LN
Vero Beach, FL 32963-4914
Phone
(772) 567-2237
Fax
(772) 567-1052
NPI assigned
Mar 22, 2007
Last updated
Aug 27, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 27, 2025

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 DN15668 FL Primary

Addresses

Primary practice location

886 Dahlia LN
Vero Beach, FL 32963-4914

Mailing address

886 Dahlia LN
Vero Beach, FL 32963-4914
Phone (772) 567-2237

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
DN15668FLMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1174521600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756252800000",
    "number": "1639295363",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "886 DAHLIA LN",
            "city": "VERO BEACH",
            "state": "FL",
            "postal_code": "329634914",
            "telephone_number": "772-567-2237",
            "fax_number": "772-567-1052"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "886 DAHLIA LN",
            "city": "VERO BEACH",
            "state": "FL",
            "postal_code": "329634914",
            "telephone_number": "772-567-2237",
            "fax_number": "772-567-1052"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAGOOD",
        "first_name": "M.",
        "middle_name": "JOHNSON",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-22",
        "last_updated": "2025-08-27",
        "certification_date": "2025-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN15668",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vero Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2025; 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.