Provider Demographics
NPI:1184791477
Name:HARTMAN, JOHN HERBERT II (DDS)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:HERBERT
Last Name:HARTMAN
Suffix:II
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5768 WASHINGTON BLVD
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46220-2541
Mailing Address - Country:US
Mailing Address - Phone:317-255-9053
Mailing Address - Fax:
Practice Address - Street 1:3091 E 98TH ST
Practice Address - Street 2:SUITE 220
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46280-2939
Practice Address - Country:US
Practice Address - Phone:317-581-0215
Practice Address - Fax:317-581-0219
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN90741223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice