NPIMap

Organization Active NPI

David C. Hagedorn DMD PSC

  • General Practice Dentistry
  • Bellevue, KY
National Provider Identifier
1811094097
Registry record updated Sep 16, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
4747 Issued in KY
Legal business name
DAVID C. HAGEDORN DMD PSC
Practice address
340 Fairfield Ave
Bellevue, KY 41073-1010
Phone
(859) 291-7621
NPI assigned
Sep 20, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 16, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. David Charles Hagedorn, DMDNPI 1528075058
Title
President
Phone
(859) 291-7621

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 4747 KY Primary

Addresses

Primary practice location

340 Fairfield Ave
Bellevue, KY 41073-1010

Mailing address

340 Fairfield Ave
Bellevue, KY 41073-1010
Phone (859) 291-7621

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1221523200000",
    "number": "1811094097",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "340 FAIRFIELD AVE",
            "city": "BELLEVUE",
            "state": "KY",
            "postal_code": "410731010",
            "telephone_number": "859-291-7621"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "340 FAIRFIELD AVE",
            "city": "BELLEVUE",
            "state": "KY",
            "postal_code": "410731010",
            "telephone_number": "859-291-7621"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DAVID C. HAGEDORN DMD PSC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-20",
        "last_updated": "2008-09-16",
        "status": "A",
        "authorized_official_last_name": "HAGEDORN",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "CHARLES",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "859-291-7621",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "KY",
            "license": "4747",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bellevue, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2008; 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.