Jack M Hosner, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

2901016078 Issued in MI

Practice address

2100 E Centre Ave
Portage, MI 49002-4494

Phone

(269) 324-1917

NPI assigned

Sep 24, 2006

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1159056000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1206316800000",
    "number": "1295835874",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2100 E CENTRE AVE",
            "city": "PORTAGE",
            "state": "MI",
            "postal_code": "490024494",
            "telephone_number": "269-324-1917"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2100 E CENTRE AVE",
            "city": "PORTAGE",
            "state": "MI",
            "postal_code": "490024494",
            "telephone_number": "269-324-1917"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOSNER",
        "first_name": "JACK",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-24",
        "last_updated": "2008-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "2901016078",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Simon Hoogendyk, M.D.
• Brandon J Hooks, D.O.
• Patricia Hoolsema, R.PH.
• Hope & Healing Therapy Services LLC
• Erin Horton, RN BSN
• Hospice Care of Southwest Michigan
• Housecall Physicians of Southwest Michigan PLC
• Christen Amanda Howard-Connor, M.A.
• Carol Ann Howard, MA LIMITED LICENSE P
• Timothy James Howard, ED.D.

• General Practice Dentistry in Portage, MI
• Providers in Portage, MI by specialty
• General Practice Dentistry in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.