Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1588662712 Individual Practitioner Male Practitioner

Dr. John Joseph Hederman , DDS

Dentist - General Practice • Port Arthur, TX

Professional Overview & Biography Verified Profile Summary

Dr. John Hederman, DDS is a registered healthcare professional specializing in Dentist - General Practice in Port Arthur, TX. Practice services are available at 2548 MEMORIAL BLVD under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

2548 Memorial Blvd

Port Arthur, TX 776402825

Telephone 4099831161
Fax 4099834933
Associated Practice Facility / Clinic
🏢 Gulf Coast Health Center Inc Facility NPI 1912904897

Specialty Benchmarks & Practice Insights

Comparative analytics for Dentist - General Practice in Port Arthur, TX

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 12.3 Yrs
Regional Practice Density
19 Specialists

Practicing in Port Arthur, TX (10570 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Dentist - General Practice Primary Specialty

NUCC Taxonomy Code: 1223G0001X

State License TX 14309

A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid State Provider ID
126826002 (TX)

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

40 Associated Practitioners
NPI 1003815093

Doctor of Osteopathic Medicine (D.O.)

Maria Diestro , FNP

Nurse Practitioner

NPI 1013916634

Family Nurse Practitioner

NPI 1053983932

Licensed Master Social Worker

Kahla Garrett

Nurse Practitioner - Family

NPI 1093348278
Richard Woodcroft , PA

Physician Assistant

NPI 1144316787

Physician Assistant

Dr. Paul Proffitt , DO

Psychiatry & Neurology - Neurology

NPI 1154308989

Doctor of Osteopathic Medicine (D.O.)

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

6 Historical Events
NPI Profile Active August 03, 2011

NPI status registered as active in NPPES database

📍
Updated Practice Location August 03, 2011

Registered at 2548 MEMORIAL BLVD, PORT ARTHUR, TX 776402825 (Tel: 4099831161)

📍
Updated Business Mailing Address August 03, 2011

Registered at 2548 MEMORIAL BLVD, PORT ARTHUR, TX 776402825 (Tel: 4099831161)

👤
Provider Name / Credentials Updated August 03, 2011

Recorded as JOHN HEDERMAN, D.D.S

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) August 03, 2011

Dentist (License #14309 in TX)

🟢
Initial NPI Registration & Enumeration July 12, 2005

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1588662712
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: July 12, 2005
Last Update: August 03, 2011
Sole Proprietor: No

Mailing Address

2548 Memorial Blvd

Port Arthur, TX 776402825

Phone: 4099831161

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.