Individual provider Active NPI

John Hanna, BDS , DDS, MACSD

  • Dentist
  • San Antonio, TX
National Provider Identifier
1639555089
Registry record updated Feb 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
30960 Issued in TX
Practice address
23535 Ih 10 W Ste 2202
San Antonio, TX 78257-1673
Phone
(210) 687-1444
NPI assigned
Aug 8, 2015
Last updated
Feb 11, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 11, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 30960 TX Primary

Addresses

Primary practice location

23535 Ih 10 W Ste 2202
San Antonio, TX 78257-1673

Mailing address

23535 Ih 10 W Ste 2202
San Antonio, TX 78257-1673
Phone (210) 687-1444

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
30960TXMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Dental Oral Care, PLLC CurrentSince Feb 23, 2025 Accepting new patients
Mooney Family & Cosmetic Dentistry, PLLC PastSince Feb 23, 2025 Accepting new patients
North Dallas Dentistry Associates, PC Past Accepting new patients

Locations

23535 W Interstate 10
Ste 2202
San Antonio, TX 78257
Phone (210) 687-1444

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1438992000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739232000000",
    "number": "1639555089",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23535 IH 10 W STE 2202",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782571673",
            "telephone_number": "210-687-1444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23535 IH 10 W STE 2202",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782571673",
            "telephone_number": "210-687-1444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HANNA",
        "first_name": "JOHN",
        "name_prefix": "Dr.",
        "credential": "BDS , DDS, MACSD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-08-08",
        "last_updated": "2025-02-11",
        "certification_date": "2025-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TX",
            "license": "30960",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2025; 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.