Healthcare Provider Details

I. General information

NPI: 1265507222
Provider Name (Legal Business Name): CHARLES DENNIS HASSE DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: CHARLES D HASSE DDS

II. Dates (important events)

Enumeration Date: 11/22/2006
Last Update Date: 04/15/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16300 SAND CANYON AVE SUITE #711
IRVINE CA
92618
US

IV. Provider business mailing address

16300 SAND CANYON AVE SUITE #711
IRVINE CA
92618
US

V. Phone/Fax

Practice location:
  • Phone: 949-727-7000
  • Fax: 949-727-3924
Mailing address:
  • Phone: 949-727-7000
  • Fax: 949-727-3924

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License NumberD28568
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: