DR. JOHN MASON HACKENBERGER (NPI# 1790730406) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1790730406 |
| Entity Type | Individual |
| Full Name | DR. JOHN MASON HACKENBERGER |
| Credential | DDS |
| Practice Address |
29427 Ryan Rd Warren MI 48092-2203 |
| Mailing Address |
29425 Ryan Rd Warren MI 48092-2203 |
| Practice Telephone | 5867559340 |
| Practice Fax Number | 5867551081 |
| Mailing Telephone | 5867559340 |
| Mailing Fax Number | 5867559341 |
| Enumeration Date | 2006-05-23 |
| Last Update Date | 2009-07-24 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223S0112X |
Dentist Specialization: Oral and Maxillofacial Surgery |
2901016237 | MI | Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | BLUE CROSS PIN | 970E07680 | 01 |
| Street Address |
29427 RYAN RD |
| City | WARREN |
| State | MI |
| Zip Code | 48092-2203 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720341886 | Arshi Lehal | Dentist | 29427 Ryan Rd, Warren, MI 48092 | 2012-06-22 |
| 1902065014 | Shyam Prasad Aravindaksha | Oral & Maxillofacial Surgery | 29427 Ryan Rd, Warren, MI 48092-2203 | 2008-06-03 |
| 1013110824 | Leslie Ann Orzech | Dentist | 29427 Ryan Rd, Warren, MI 48092-2203 | 2007-06-08 |
| 1811066129 | Summit Oral & Maxillofacial Surgery PC | Dentist | 29427 Ryan Rd, Warren, MI 48092-2203 | 2006-11-08 |
| 1912947227 | Gregory James Thomas | Dentist | 29427 Ryan Rd, Warren, MI 48092-2203 | 2006-06-07 |
| 1366480238 | Michael Bartholomew Kraemer | Dentist | 29427 Ryan Rd, Warren, MI 48092-2203 | 2006-06-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881163186 | Katherine Byrd | Behavior Technician | 3691 East 11 Mile Rd., Warren, MI 48092 | 2018-11-15 |
| 1861980302 | Mark Paul Azzo | Home Health Aide | 27605 Walker Ave, Warren, MI 48092 | 2018-04-30 |
| 1144747130 | Joseph Galutan Estrada | Chiropractor | 4846 Marlow Dr, Warren, MI 48092 | 2017-08-29 |
| 1649669425 | Lawrence Mosurak IIi | Chiropractor | 6201 Chicago Road, Warren, MI 48092 | 2015-01-15 |
| 1174911713 | Kimberly A Ott | Nurse Practitioner | 28800 Ryan Rd Suite 320, Warren, MI 48092 | 2015-01-06 |
| 1487071999 | Michele Szandzik | Chiropractor | 2243 East 12 Mile Rd, Warren, MI 48092 | 2014-03-21 |
| 1962827311 | Mouradian Dental Center, D.d.s., P.C. | Dentist | 32500 Mound Rd., Mouradian Dental Center, D.d.s., P.C., Warren, MI 48092 | 2014-02-21 |
| 1639495930 | Debra Kay Wenneman | Physical Therapist | 28776 Ryan Rd, Warren, MI 48092 | 2010-04-12 |
| 1922332923 | Sonia Amirali Pethani | Physical Therapist | 2117 E. Eleven Mile Rd., Warren, MI 48092 | 2009-09-23 |
| 1881822237 | Michael Patrick Walsh | Orthopaedic Surgery | 28800 Ryan Rd Ste 310, Warren, MI 48092 | 2009-06-24 |
| Find all providers in zip 48092 | ||||
| Taxonomy Code | 1223S0112X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Oral and Maxillofacial Surgery |
| The specialty of dentistry which includes the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740624121 | Prakhar Mehrotra | Dentist | 58 Mount Bethel Rd Ste 202, Warren, NJ 07059 | 2013-04-29 |
| 1770848129 | Bradley Dental | Dentist | 21635 Ryan Rd, Warren, MI 48091-2788 | 2012-07-11 |
| 1912017336 | Michael B. Krzemien | Dentist | 12000 E 12 Mile Rd, Warren, MI 48093-3570 | 2006-08-30 |
| 1033163886 | Terry B Philibin | Dentist | 405 Niles Cortland Rd Se, Suite #101, Warren, OH 44484-2460 | 2006-05-19 |
| 1124089545 | Jeffrey Richard Mcclain | Dentist | 8893 E Market St, Warren, OH 44484-2351 | 2006-03-28 |
| 1366442212 | Steven M. Wolf | Dentist | 25916 Dequindre Rd, Warren, MI 48091-6112 | 2005-07-21 |
| 1750766358 | Taneenop Aramphongphan | Dentist | 58 Mount Bethel Rd Ste 202, Warren, NJ 07059-2655 | 2015-07-23 |
| 1376923623 | Mark Grinzinger | Dentist | 12000 E 12 Mile Rd, Warren, MI 48093-3570 | 2015-06-02 |
| 1720341886 | Arshi Lehal | Dentist | 29427 Ryan Rd, Warren, MI 48092 | 2012-06-22 |
| 1447548607 | Warren Oral & Maxillofacial Surgery Associates, LLC | Dentist | 58 Mount Bethel Rd, Suite 202, Warren, NJ 07059-2654 | 2011-07-21 |
| Find all providers in WARREN | ||||
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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.