Jessica Yvette Hackman, MD, DMD

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

OMS58 Issued in CA

Practice address

9921 Carmel Mountain Rd
#186
San Diego, CA 92129-2813

Phone

(310) 709-2418

NPI assigned

Oct 27, 2006

Sex

Female

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

Enrolled in CA

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

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1161907200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1326758400000",
    "number": "1619053170",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9921 CARMEL MOUNTAIN RD",
            "address_2": "#186",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921292813",
            "telephone_number": "310-709-2418"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9921 CARMEL MOUNTAIN RD",
            "address_2": "#186",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921292813",
            "telephone_number": "310-709-2418"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HACKMAN",
        "first_name": "JESSICA",
        "middle_name": "YVETTE",
        "credential": "MD, DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-27",
        "last_updated": "2012-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "CA",
            "license": "OMS58",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Scott Curran Hacker, P.T., D.P.T.
• Katrina M Hackett, D.C, A.T.C, C.S.C.S,
• Robert George Hackim, D.D.S.
• De'Ron Hackler
• Leslie Ann Hackley, R.D.
• Stephanie Hackman, MD
• Robert Jeremy Hackworth, M.D.
• Shana L. Hackworth
• Alison Hadavi, RDN
• Wayne Hadaway Jr., DDS

• Oral and Maxillofacial Surgery (Dentist) in San Diego, CA
• Providers in San Diego, CA by specialty
• Oral and Maxillofacial Surgery (Dentist) in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.