DR. JOHN MASON HACKENBERGER (DDS) – Oral and Maxillofacial Surgery (Dentist), NPI 1790730406

DR. JOHN MASON HACKENBERGER (DDS) is a healthcare provider. based in Warren, Michigan. specializing in MAXILLOFACIAL SURGERY, ORAL SURGERY. They hold the professional credentials DDS. They hold a License No. 2901016237 (MI). The NPI Number for DR. JOHN MASON HACKENBERGER (DDS) is 1790730406

Main info

Male
37 Years Of Experience
Accepts Medicare Assignment
Name
DR. JOHN MASON HACKENBERGER (DDS)
NPI
1790730406
Phone
(586) 755-9340
Address
29425 RYAN RD
Enumeration Date
23 May 2006
Last Update Date
24 July 2009

Doctor Profile

Medical School Name
UNIVERSITY OF MICHIGAN MEDICAL SCHOOL
Secondary Phone
5867559340
Graduation Year
1989 (37 years ago)
PAC ID
4486621786
Group Practice PAC ID
5991772287
Professional Enrollment ID
I20070730000120
Address ID
MI480922203WA29427RDXX300
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience54
Completeness75
Years active:20State licenses:1Digital endpointsOther names

76 MAXILLOFACIAL SURGERY in MI

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Provider Addresses for DR. JOHN MASON HACKENBERGER (DDS)

  • Ryan Road, Warren, Macomb County, Michigan, 48092, United States

    WARREN, MI 480922203

    Phone: (586) 755-9340

    Fax: (586) 755-9341

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 21 Open Payments records for all available years, with a total value of $1,938.

Total Amount is formed as General ($1,938) + Research ($0) + Ownership ($0) = $1,938.

Last reported payment date: 2024-09-30 • Largest payer in this snapshot: ZIMVIE INC. ($1,895).

Total Amount

$1,938

General + Research + Ownership

Payments

21

Total payment records

General Amount

$1,938

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-09-30

Latest reported date

Top Companies

Largest payers in this snapshot

View all Open Payments →|Open Payments Risk Radar →

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2007-07-30

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20070730000120IMaxillofacial SurgeryMITBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
99202New patient office or other outpatient visit, 15-29 minutes2121$0
View full utilization report →

Insurance plans in this area (ZIP 48092)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 5991772287View full group profile
NameSpecialtyState
Oral Surgery, Maxillofacial SurgeryMI
Oral And Maxillofacial PathologyMI
Maxillofacial Surgery, Oral SurgeryMI
Oral SurgeryMI
Maxillofacial Surgery, Oral SurgeryMI
Maxillofacial Surgery, Oral SurgeryMI
-MI

Reviews

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Frequently asked questions

What federal number belongs to DR. JOHN MASON HACKENBERGER (DDS)?
The federal identifier for DR. JOHN MASON HACKENBERGER (DDS) is NPI 1790730406.
Does this profile mean DR. JOHN MASON HACKENBERGER (DDS) is currently active?
Yes — DR. JOHN MASON HACKENBERGER (DDS) appears active in the national provider directory.
What does DR. JOHN MASON HACKENBERGER (DDS) treat or focus on?
Patients typically see DR. JOHN MASON HACKENBERGER (DDS) under the specialty Oral and Maxillofacial Surgery (Dentist). Clinical services aligned with this taxonomy classification.
Where is DR. JOHN MASON HACKENBERGER (DDS)'s primary listing?
We display Warren, Michigan because that is what the record indicates for DR. JOHN MASON HACKENBERGER (DDS).
Is this NPI for an individual or an organization?
This listing corresponds to an Individual Provider.

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