Steven Philip Hackmyer, D.D.S.

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

D009096 Issued in AZ

Practice address

Fort Defiance Indian Hospital
Corner of Route N12 and N7
Fort Defiance, AZ 86504

Phone

(928) 729-8000

NPI assigned

Nov 28, 2006

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)

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.

• The Wallace Medical Concern

  • Primary Care Clinic/Center
  • Portland, OR
  • NPI 1215390091
  NPD (past)

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

{
    "created_epoch": "1164672000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1571184000000",
    "number": "1548336597",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 649",
            "city": "FORT DEFIANCE",
            "state": "AZ",
            "postal_code": "865040649",
            "telephone_number": "928-729-8000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "FORT DEFIANCE INDIAN HOSPITAL",
            "address_2": "CORNER OF ROUTE N12 AND N7",
            "city": "FORT DEFIANCE",
            "state": "AZ",
            "postal_code": "86504",
            "telephone_number": "928-729-8000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HACKMYER",
        "first_name": "STEVEN",
        "middle_name": "PHILIP",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-28",
        "last_updated": "2019-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "AZ",
            "license": "D009096",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joe Allen Griffin, CRNA
• Zoe Grimes, RN BSN
• Daniel Mireles Guerrero, RTT
• Pablo Guerrero, PT
• Jay S Guikema, FNP
• Karar Haider, RRT
• Zia Haider
• Kelly Aleen Haines, FNP-C
• Angelica Michelle Hamilton
• Monica Nicole Hammond, RN

• Pediatric Dentistry in Fort Defiance, AZ
• Providers in Fort Defiance, AZ by specialty
• Pediatric Dentistry in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2019; 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.