Provider Demographics
NPI:1265507222
Name:HASSE, CHARLES DENNIS (DDS)
Entity Type:Individual
Prefix:MR
First Name:CHARLES
Middle Name:DENNIS
Last Name:HASSE
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:DR
Other - First Name:CHARLES
Other - Middle Name:D
Other - Last Name:HASSE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DDS
Mailing Address - Street 1:16300 SAND CANYON AVE
Mailing Address - Street 2:SUITE #711
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92618
Mailing Address - Country:US
Mailing Address - Phone:949-727-7000
Mailing Address - Fax:949-727-3924
Practice Address - Street 1:16300 SAND CANYON AVE
Practice Address - Street 2:SUITE #711
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92618
Practice Address - Country:US
Practice Address - Phone:949-727-7000
Practice Address - Fax:949-727-3924
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-22
Last Update Date:2013-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAD285681223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA036750851OtherADA