Active NPI
David J Hageman, DDS
- General Practice Dentistry
- Dallas, TX
National Provider Identifier
1720194343
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 8184
- Practice address
- 3606 Marvin D Love Fwy
Dallas, TX 75224-4442 - Phone
- (214) 371-4763
- Fax
- (214) 372-6057
- NPI assigned
- Aug 23, 2006
- Sex
- Male
- 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 |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 8184 | TX | Primary |
Addresses
Primary practice location
3606 Marvin D Love Fwy
Dallas, TX 75224-4442
Mailing address
3606 Marvin D Love Fwy
Dallas, TX 75224-4442
Phone (214) 371-4763
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160614001964 | TX | Order and Referring Only - Dentist | 2567753031 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Dr. Hageman DDS | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Dentist
- Dallas, TX
- NPI 1437319878
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156291200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1189641600000",
"number": "1720194343",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3606 MARVIN D LOVE FWY",
"city": "DALLAS",
"state": "TX",
"postal_code": "752244442",
"telephone_number": "214-371-4763",
"fax_number": "214-372-6057"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3606 MARVIN D LOVE FWY",
"city": "DALLAS",
"state": "TX",
"postal_code": "752244442",
"telephone_number": "214-371-4763",
"fax_number": "214-372-6057"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HAGEMAN",
"first_name": "DAVID",
"middle_name": "J",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-08-23",
"last_updated": "2007-09-13",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "TX",
"license": "8184",
"primary": true
}
],
"identifiers": [],
"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 Sep 13, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.