NPIMap

Organization Active NPI

William J. Hagerty Dental Associates LLC

  • General Practice Dentistry
  • Centerville, OH
National Provider Identifier
1992097257
Registry record updated May 5, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
16938 Issued in OH
Legal business name
WILLIAM J. HAGERTY DENTAL ASSOCIATES LLC
Practice address
303 N. Main St.
Suite 103
Centerville, OH 45459-2565
Phone
(937) 433-6903
NPI assigned
May 5, 2011
Last updated
May 5, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 5, 2011

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

Authorized official

Name
Penny A Rogers
Title
Office Manager
Phone
(937) 433-8303

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223G0001X 16938 OH Primary

Addresses

Primary practice location

303 N. Main St.
Suite 103
Centerville, OH 45459-2565

Mailing address

7058 Corporate Way
Suite 1
Dayton, OH 45459-4295
Phone (937) 433-8303

National Provider Directory

National Provider Directory
Tax ID family
Centerville Dental Associates5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

Locations

7058 Corporate Way
Ste 1
Dayton, OH 45459
Phone (937) 433-8303

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1304553600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1304553600000",
    "number": "1992097257",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7058 CORPORATE WAY",
            "address_2": "SUITE 1",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454594295",
            "telephone_number": "937-433-8303"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "303 N. MAIN ST.",
            "address_2": "SUITE 103",
            "city": "CENTERVILLE",
            "state": "OH",
            "postal_code": "454592565",
            "telephone_number": "937-433-6903"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILLIAM J. HAGERTY DENTAL ASSOCIATES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-05-05",
        "last_updated": "2011-05-05",
        "status": "A",
        "authorized_official_last_name": "ROGERS",
        "authorized_official_first_name": "PENNY",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "937-433-8303"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "OH",
            "license": "16938",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Centerville, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2011; 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.