Individual provider Active NPI

An N Hamman, D.M.D.

  • General Practice Dentistry
  • Jeffersonville, IN
National Provider Identifier
1790197218
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
12012103A Issued in IN
Practice address
2310 Allison LN
Jeffersonville, IN 47130-5819
Phone
(812) 288-7135
NPI assigned
Jun 2, 2014
Last updated
Mar 17, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 12012103A IN Primary

Addresses

Primary practice location

2310 Allison LN
Jeffersonville, IN 47130-5819

Mailing address

16 Ridge Rd
Louisville, KY 40205-2019
Phone (502) 709-3989

Other practice location 1

923 Ellison Ave
Louisville, KY 40204-1901
Phone (502) 709-3989

Other identifiers 1

IdentifierTypeStateIssuer
201235660MedicaidIN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
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
I20250606002584 KY Order and Referring Only - DentistPractitioner - Dentist 5799064580

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
12012103AINMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Shoemaker Family Dental Past Accepting new patients

Organizations & group practices 1

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": "1401667200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1790197218",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16 RIDGE RD",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402052019",
            "telephone_number": "502-709-3989"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2310 ALLISON LN",
            "city": "JEFFERSONVILLE",
            "state": "IN",
            "postal_code": "471305819",
            "telephone_number": "812-288-7135"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "923 Ellison Ave",
            "address_purpose": "LOCATION",
            "city": "Louisville",
            "state": "KY",
            "postal_code": "402041901",
            "country_code": "US",
            "telephone_number": "502-709-3989",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HAMMAN",
        "first_name": "AN",
        "middle_name": "N",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-06-02",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IN",
            "license": "12012103A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201235660",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jeffersonville, IN

Sources for this page

Verify at the official NPI Registry.