Lawrence William Hagen II, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

16063 Issued in OH

Practice address

4998 Glenway Ave
Cincinnati, OH 45238-3902

Phone

(513) 251-5500

Fax

(513) 251-0687

NPI assigned

Aug 18, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in OH

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Covedale Dental Studio LLC

  • General Practice Dentistry
  • Cincinnati, OH
  • NPI 1801724182
  NPD (past)
• Western Hills Dental Center LLC

  • General Practice Dentistry
  • Cincinnati, OH
  • NPI 1558931626
  NPD (past)

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

{
    "created_epoch": "1155859200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1851405864",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4998 GLENWAY AVE",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452383902",
            "telephone_number": "513-251-5500",
            "fax_number": "513-251-0687"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4998 GLENWAY AVE",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452383902",
            "telephone_number": "513-251-5500",
            "fax_number": "513-251-0687"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAGEN",
        "first_name": "LAWRENCE",
        "middle_name": "WILLIAM",
        "name_prefix": "Dr.",
        "name_suffix": "II",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-18",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OH",
            "license": "16063",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Andrew Hagelman
• Sierra Cheyanne Hageman
• Bridgette Lynn Hagen, PMHNP
• Elizabeth Hagen
• Jessica Hagen
• Leanne Hagen
• Matthew Carlisle Hagen, M.D., PH.D.
• Rachael Hagenbarth
• Amanda K. Hager, MA, LPCC
• Marie D Hager

• General Practice Dentistry in Cincinnati, OH
• Providers in Cincinnati, OH by specialty
• General Practice Dentistry in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.

Verify at the official NPI Registry.