John Heffernan Jr., D.D.S

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

30.024446 Issued in OH

Practice address

1832 Pearl Rd
Brunswick, OH 44212-3252

Phone

(330) 460-3016

NPI assigned

May 21, 2012

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in OH

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

State licenses

Practice roles

Locations

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

• Advanced Dentistry - Heffernan DDS LLC

  • Dentist
  • Brunswick, OH
  • NPI 1891367488
  NPD Authorized official

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

{
    "created_epoch": "1337558400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733788800000",
    "number": "1417217795",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1236 MICHIGAN AVE",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432013116"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1832 PEARL RD",
            "city": "BRUNSWICK",
            "state": "OH",
            "postal_code": "442123252",
            "telephone_number": "330-460-3016"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEFFERNAN",
        "first_name": "JOHN",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "D.D.S",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-05-21",
        "last_updated": "2024-12-10",
        "certification_date": "2024-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OH",
            "license": "30.024446",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alexandra M Harvan, CNP
• Brittany Hayes, QMHS
• Shannon Hearns
• Heartfelt Homecare LLC
• Heather Kurtz
• Evelyn Morley Hemmingsen, MD
• Hendricks Family Dentistry Inc.
• Gary F Hendricks, DDS
• Jamison P Hendricks, D.D.S.
• Kimberly Renee Hennigan

• General Practice Dentistry in Brunswick, OH
• Providers in Brunswick, OH by specialty
• General Practice Dentistry in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2024; 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.