Active NPI
Dylan Hagerty, DMD
- Dentist
- Ruskin, FL
National Provider Identifier
1780947416
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- DN19794
- Practice address
- 902 N US Highway 41
Ruskin, FL 33570-3544 - Phone
- (813) 645-6491
- NPI assigned
- Jun 18, 2012
- 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 |
|---|---|---|---|---|
| Dentist | 122300000X | DN19794 | FL | Primary |
Addresses
Primary practice location
902 N US Highway 41
Ruskin, FL 33570-3544
Mailing address
902 N US Highway 41
Ruskin, FL 33570-3544
Phone (813) 645-6491
Other practice location 1
3001 Enterprise Rd E
Clearwater, FL 33759-1304
Phone (727) 791-9393
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL
- 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 |
|---|---|---|---|---|
| I20160426001549 | FL | Order and Referring Only - Oral Surgery | 5890094825 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DN19794 | FL | MD | Dentist |
Networks
- Freedom Health HMO Network
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1339977600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1524096000000",
"number": "1780947416",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "902 N US HIGHWAY 41",
"city": "RUSKIN",
"state": "FL",
"postal_code": "335703544",
"telephone_number": "813-645-6491"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "902 N US HIGHWAY 41",
"city": "RUSKIN",
"state": "FL",
"postal_code": "335703544",
"telephone_number": "813-645-6491"
}
],
"practiceLocations": [
{
"address_1": "3001 Enterprise Rd E",
"address_purpose": "LOCATION",
"city": "Clearwater",
"state": "FL",
"postal_code": "337591304",
"country_code": "US",
"telephone_number": "727-791-9393",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "HAGERTY",
"first_name": "DYLAN",
"name_prefix": "Dr.",
"credential": "DMD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2012-06-18",
"last_updated": "2018-04-19",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "FL",
"license": "DN19794",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ruskin, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2018; 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.