Healthcare Provider Details

I. General information

NPI: 1407628399
Provider Name (Legal Business Name): JEFFREY PIERRE HAGE DMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/25/2023
Last Update Date: 05/19/2026
Certification Date: 05/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1285 SPRINGFIELD ST # 1
FEEDING HILLS MA
01030-2179
US

IV. Provider business mailing address

15 AUSTIN BROOK DR
EAST GRANBY CT
06026-9313
US

V. Phone/Fax

Practice location:
  • Phone: 413-786-4000
  • Fax:
Mailing address:
  • Phone: 203-767-7548
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License NumberDN10001248
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: