Jerame Kent Hafen, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

25021 Issued in TX

Practice address

8056 Shin Oak Dr
Ste 100
Live Oak, TX 78233

Phone

(210) 658-3131

Fax

(210) 658-9033

NPI assigned

Sep 24, 2009

Sex

Male

Sole proprietor

No

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not 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.

• Olympia Hills Family Dental, PC

  • General Practice Dentistry
  • Live Oak, TX
  • NPI 1619371689

  General Practice

  NPD Authorized official
• Live Oak Pediatric Dentistry

  • Pediatric Dentistry
  • Live Oak, TX
  • NPI 1932813219

  General Practice

  NPD (past) Authorized official

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

{
    "created_epoch": "1253750400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1650412800000",
    "number": "1497089346",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8056 SHIN OAK DR",
            "address_2": "STE 100",
            "city": "LIVE OAK",
            "state": "TX",
            "postal_code": "78233",
            "telephone_number": "210-658-3131",
            "fax_number": "210-658-9033"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8056 SHIN OAK DR",
            "address_2": "STE 100",
            "city": "LIVE OAK",
            "state": "TX",
            "postal_code": "78233",
            "telephone_number": "210-658-3131",
            "fax_number": "210-658-9033"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAFEN",
        "first_name": "JERAME",
        "middle_name": "KENT",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-09-24",
        "last_updated": "2022-04-20",
        "certification_date": "2022-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "25021",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kimberly Ann Guajardo, APRN, FNP-C
• Yesenia Mari Guerra, LPC
• Karen Tarm Guerrero, M.D.
• Chloe Lynne Guillen, LMSW
• Elise Danielle Guzme, APRN, FNP-BC
• Tori Haffner
• Gary Marvin Hall, MD
• La'Daiza Jordyn Hall
• Crystal Halsey, CCC-SLP
• Hamilton County Hospital District

• All providers in Live Oak, TX
• General Practice Dentistry in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2022; 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.