Individual provider Active NPI

John Joseph Hanks, DDS

  • General Practice Dentistry
  • Grand Rapids, MI
National Provider Identifier
1306964374
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
D11563 Issued in MI
Practice address
2730 Five Mile Road NE
Suite 101
Grand Rapids, MI 49525-6518
Phone
(616) 364-7039
Fax
(616) 364-6068
NPI assigned
Mar 27, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X D11563 MI Primary

Addresses

Primary practice location

2730 Five Mile Road NE
Suite 101
Grand Rapids, MI 49525-6518

Mailing address

2730 Five Mile Road NE
Suite 101
Grand Rapids, MI 49525-6518
Phone (616) 364-7039

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
D11563MIMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Jacob S Miller, DDS, PLLC General Practice Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1174953600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1306964374",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2730 FIVE MILE ROAD NE",
            "address_2": "SUITE 101",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495256518",
            "telephone_number": "616-364-7039",
            "fax_number": "616-364-6068"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2730 FIVE MILE ROAD NE",
            "address_2": "SUITE 101",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495256518",
            "telephone_number": "616-364-7039",
            "fax_number": "616-364-6068"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HANKS",
        "first_name": "JOHN",
        "middle_name": "JOSEPH",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-27",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "D11563",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Rapids, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.