KENNETH J. HAGEN JR. (NPI# 1780668996) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1780668996 |
| Entity Type | Individual |
| Full Name | KENNETH J. HAGEN JR. |
| Credential | DDS |
| Practice Address |
2811 N 90th St Omaha NE 68134-5707 |
| Practice Telephone | 4023910459 |
| Practice Fax Number | 4023848888 |
| Mailing Telephone | 4023910459 |
| Mailing Fax Number | 4023848888 |
| Enumeration Date | 2005-12-01 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | X |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
4646 | NE | Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NE | UNITED CONCORDIA ID# | 132485 | 01 |
| NE | 47063287713 | 05 | |
| NE | BCBS PROVIDER ID | 5807 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750353959 | Kenneth J Hagen | Social Worker | 3500 Sw 6th Ave, Suite 116, Topeka, KS 66606-2806 | 2006-02-02 |
| Street Address |
2811 N 90TH ST |
| City | OMAHA |
| State | NE |
| Zip Code | 68134-5707 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528238995 | Family Dental Associates | Dentist | 2811 N 90th St, Omaha, NE 68134-5707 | 2008-03-03 |
| 1013991231 | Hal T Ritchie | Dentist | 2811 N 90th St, Omaha, NE 68134-5707 | 2005-12-01 |
| 1629052840 | Reid C Wycoff | Dentist | 2811 N 90th St, Omaha, NE 68134-5707 | 2005-12-01 |
| 1598749749 | Dennis Huffman | Dentist | 2811 N 90th St, Omaha, NE 68134-5707 | 2005-12-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659802262 | Destinee Myres | Registered Nurse | 9270 Ames Ave, Omaha, NE 68134 | 2017-03-24 |
| 1689062861 | Good Hope Healthcare, Inc. | Skilled Nursing Facility | 7501 Keystone Drive, Omaha, NE 68134 | 2014-12-22 |
| 1538557772 | Megan Pendley | Counselor | 2808 North 75th Street, Omaha, NE 68134 | 2014-12-22 |
| 1477823771 | Warren Leonard Wallin | Pharmacist | 5225 North 90 St Street, Omaha, NE 68134 | 2012-01-04 |
| 1851613731 | Bobbi J Bussart | Counselor | 5843 N 90th, Omaha, NE 68134 | 2010-02-19 |
| 1386879559 | Makovicka Harms Group PC | Physical Therapist | 4201 N 90th Street, Omaha, NE 68134 | 2009-05-18 |
| 1093906216 | Deepthi Samindla | Family Medicine | 4229 North 90th Street, Omaha, NE 68134 | 2007-08-05 |
| 1740489384 | Tami Michelle Teut | Occupational Therapist | 7300 Graceland Drive, Omaha, NE 68134 | 2007-07-13 |
| 1447389200 | Mary Jo Atwood | Counselor | 10642 Old Maple Rd, Omaha, NE 68134 | 2007-03-05 |
| 1568502391 | Kimberly Lavern Mcmorris | Counselor | 2805 N 72 Street, Omaha, NE 68134 | 2007-02-08 |
| Find all providers in zip 68134 | ||||
| Taxonomy Code | 1223G0001X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | General Practice |
| 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. |
| Notes: Source: Academy of General Dentistry |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982240024 | Autumn Brown | Dentist | 989375 Nebraska Medical Ctr Fl Center3, Omaha, NE 68198-9375 | 2019-11-25 |
| 1407411507 | Today's Dental 74th Plaza, LLC | Dentist | 900 S 74th Plz Ste 300, Omaha, NE 68114-4667 | 2019-05-03 |
| 1104390855 | Millard Hills Dental Health Center LLC | Dentist | 14202 Y Street, Omaha, NE 68137 | 2019-01-16 |
| 1184119547 | Nbd Lincoln PC | Dentist | 2456 S 120th St, Omaha, NE 68144-2811 | 2018-06-28 |
| 1538664255 | Ss Green & Dentistry Associates LLC | Dentist | 3525 N 147th St Ste 213, Omaha, NE 68116-8262 | 2018-03-26 |
| 1487155073 | Nicole T Nelson | Dentist | 5805 Manderson St, Omaha, NE 68104-2939 | 2018-02-28 |
| 1588176887 | Jerald E. Mcmanigal, Dds, PC | Dentist | 13518 W Center Rd, Omaha, NE 68144-3408 | 2017-10-27 |
| 1467971457 | James Donald O'meara | Dentist | 780729 California Plz, Omaha, NE 68178-0012 | 2017-09-12 |
| 1801318142 | Trason Lyle Shoquist | Dentist | 15304 Howe St, Omaha, NE 68144-5416 | 2017-07-07 |
| 1144750449 | John Paul Kersenbrock | Dentist | 13808 W Maple Rd Ste 112, Omaha, NE 68164-6231 | 2017-06-19 |
| Find all providers in OMAHA | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.