Individual provider Active NPI

David J Hageman, DDS

  • General Practice Dentistry
  • Dallas, TX
National Provider Identifier
1720194343
Registry record updated Sep 13, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
8184 Issued in TX
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

Updated by the provider on Sep 13, 2007

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 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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160614001964 TX Order and Referring Only - DentistPractitioner - Dentist 2567753031

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew 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.

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

Verify at the official NPI Registry.