Individual provider Active NPI

John Douglas Hamerink, D.D.S.

  • Dentist
  • Plymouth, MI
National Provider Identifier
1679880728
Registry record updated Sep 10, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
2901020262 Issued in MI
Practice address
159 S. Harvey St
Plymouth, MI 48170
Phone
(734) 455-8686
NPI assigned
Sep 10, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 10, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 2901020262 MI Primary

Addresses

Primary practice location

159 S. Harvey St
Plymouth, MI 48170

Mailing address

159 S Harvey St
Plymouth, MI 48170-1615
Phone (734) 455-8686

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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

Enrollment IDStateProvider typePAC IDDetails
I20160525000884 MI Order and Referring Only - DentistPractitioner - Dentist 9335438779

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2901020262MIMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Eden Counseling, LLC PastSince Jun 14, 2020 Accepting new patients
Emotional Empowerment Services PLLC PastSince Jun 28, 2020 Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1284076800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1284076800000",
    "number": "1679880728",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "159 S HARVEY ST",
            "city": "PLYMOUTH",
            "state": "MI",
            "postal_code": "481701615",
            "telephone_number": "734-455-8686"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "159 S. HARVEY ST",
            "city": "PLYMOUTH",
            "state": "MI",
            "postal_code": "48170",
            "telephone_number": "734-455-8686"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAMERINK",
        "first_name": "JOHN",
        "middle_name": "DOUGLAS",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-09-10",
        "last_updated": "2010-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MI",
            "license": "2901020262",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Plymouth, MI

Sources for this page

Verify at the official NPI Registry.