Individual provider Active NPI

John Howard Hardeman, MD, DDS

  • Oral and Maxillofacial Surgery (Dentist)
  • Gainesville, FL
National Provider Identifier
1447343918
Registry record updated Nov 17, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
DN 12910 Issued in FL
Practice address
1600 SW Archer Rd
Box 100425
Gainesville, FL 32610-0405
Phone
(352) 273-6750
Fax
(352) 392-7609
NPI assigned
Oct 2, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 17, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist) 1223S0112X DN 12910 FL Primary
Oral & Maxillofacial Surgery (D.M.D.) 204E00000X ME59580 FL

Addresses

Primary practice location

1600 SW Archer Rd
Box 100425
Gainesville, FL 32610-0405

Mailing address

1600 SW Archer Rd
Box 100425
Gainesville, FL 32610-0405
Phone (352) 273-6750

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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

Enrollment IDStateProvider typePAC IDDetails
I20040514000256 FL Practitioner - Oral SurgeryPractitioner - General Surgery 0244220093 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
DN 12910FLMDOral and Maxillofacial Surgery (Dentist)
ME59580FLMDOral & Maxillofacial Surgery (D.M.D.)

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1159747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1416182400000",
    "number": "1447343918",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1600 SW ARCHER RD",
            "address_2": "BOX 100425",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326100405",
            "telephone_number": "352-273-6750",
            "fax_number": "352-392-7609"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 SW ARCHER RD",
            "address_2": "BOX 100425",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326100405",
            "telephone_number": "352-273-6750",
            "fax_number": "352-392-7609"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARDEMAN",
        "first_name": "JOHN",
        "middle_name": "HOWARD",
        "name_prefix": "Dr.",
        "credential": "MD, DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-02",
        "last_updated": "2014-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "FL",
            "license": "DN 12910",
            "primary": true
        },
        {
            "code": "204E00000X",
            "taxonomy_group": "",
            "desc": "Oral & Maxillofacial Surgery",
            "state": "FL",
            "license": "ME59580",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gainesville, FL

Sources for this page

Verify at the official NPI Registry.