KENNETH J. HAGEN DDS NPI 1780668996

NPI Information

NPI: 1780668996
Provider Name: KENNETH J. HAGEN, DDS
Classification: Dentist - 1223G0001X
Entity Type: Individual

Specialization: General Practice

Address:
2811 N 90TH ST
OMAHA, NE
ZIP 68134
Phone: (402) 391-0459
Get Directions

Kenneth J. Hagen, DDS is a general practice dentist in Omaha, NE. The provider is a general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. Kenneth J. Hagen, DDS NPI is 1780668996. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

2811 N 90TH ST
OMAHA, NE
ZIP 68134-707
Phone: (402) 391-0459
Fax: (402) 384-8888

The enumeration date for this NPI number is 12/1/2005 and was last updated on 7/8/2007.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	1223G0001X	Dentist	General Practice	4646	NEBRASKA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	132485	OTHER	NEBRASKA	UNITED CONCORDIA ID#
2	47063287713	MEDICAID	NEBRASKA
3	5807	OTHER	NEBRASKA	BCBS PROVIDER ID

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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