Jeremy Mark Hannon, D.M.D.

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

DT2297 Issued in HI

Practice address

45-1144 Kamehameha Hwy Ste #301
Kaneohe, HI 96744

Phone

(808) 230-8000

NPI assigned

Aug 28, 2007

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

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Sep 5, 2017 through Sep 5, 2027

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Oahu Oral and Maxillofacial Surgery

  • Oral and Maxillofacial Surgery (Dentist)
  • Honolulu, HI
  • NPI 1952941817
  NPD (past)
• Gelfman and Birnbaum Oral Surgery P.C.

  • Oral and Maxillofacial Surgery (Dentist)
  • Brooklyn, NY
  • NPI 1538339072
  NPD (past)

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

{
    "created_epoch": "1188259200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1351555200000",
    "number": "1457545063",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "45-1144 KAMEHAMEHA HWY STE #301",
            "city": "KANEOHE",
            "state": "HI",
            "postal_code": "96744",
            "telephone_number": "808-230-8000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "45-1144 KAMEHAMEHA HWY STE #301",
            "city": "KANEOHE",
            "state": "HI",
            "postal_code": "96744",
            "telephone_number": "808-230-8000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HANNON",
        "first_name": "JEREMY",
        "middle_name": "MARK",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-08-28",
        "last_updated": "2012-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "HI",
            "license": "DT2297",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03388570",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "696908",
            "state": "HI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Susan Halvorsen
• Winter C Hamada, PH.D.
• Destinee M Hanaike-Macpherson
• Staci Hanashiro
• Maureen Elizabeth Hannan, PA-C
• Happy Space LLC
• Patricia Ann Harnish, PH.D.
• Hawaii Dental Group, Inc.
• Hawaii Holistic Therapy
• Regina Mae Hawkes, MT

• Oral and Maxillofacial Surgery (Dentist) in Kaneohe, HI
• Providers in Kaneohe, HI by specialty
• Oral and Maxillofacial Surgery (Dentist) in Hawaii

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2012; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.