DR. JOHN MASON HACKENBERGER DDS NPI 1790730406

NPI Information

  • NPI: 1790730406
  • Provider Name: DR. JOHN MASON HACKENBERGER, DDS
  • Classification: Dentist - 1223S0112X
  • Specialization: Oral and Maxillofacial Surgery
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 29427 RYAN RD
    WARREN, MI
    ZIP 48092
  • Phone: (586) 755-9340

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NPI Details

DR. John Mason Hackenberger, DDS is an oral and maxillofacial surgery dentist in Warren, MI with 37 years of experience. The provider is an oral and maxillofacial surgery dentist specialized in 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. DR. John Mason Hackenberger, DDS NPI is 1790730406. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

Education
Medical School: UNIVERSITY OF MICHIGAN MEDICAL SCHOOL
Graduation Year:1989

The provider's business location address is:

29427 RYAN RD
WARREN, MI
ZIP 48092-203
Phone: (586) 755-9340
Fax: (586) 755-1081

The NPI 1790730406 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.

  • New patient office or other outpatient visit, 15-29 minutes (HCPCS:99202)
  • Office or other outpatient visit for the evaluation and management of established patient that may not require presence of healthcare professional (HCPCS:99211)
  • X-ray of lower jaws, upper jaws and teeth (HCPCS:70355)

The enumeration date for this NPI number is 5/23/2006 and was last updated on 7/24/2009.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
11223S0112XDentistOral and Maxillofacial Surgery2901016237MICHIGANYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1970E07680OTHERMICHIGANBLUE CROSS PIN
2U42356MEDICARE UPINMICHIGAN
30E0768005MEDICARE ID-TYPE UNSPECIFIEDMICHIGAN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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