Hendrik Johannes De Jager, M.D.
Specialist in San Bernardino, CA. Individual provider (NPI-1).
NPI number1043398282
StatusActive
Last updated in NPPESJun 24, 2010
Details
- NPI
- 1043398282
- Entity type
- Individual (NPI-1)
- Name
- Hendrik Johannes De Jager
- Credential
- M.D.
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Nov 2, 2006
- Last updated
- Jun 24, 2010
Medicare and OIG
- Medicare enrolled (PECOS)
- Yes · PRACTITIONER - MAXILLOFACIAL SURGERY
- Can order and refer
- Part B Yes · DME Yes · Home health Yes · Power mobility Yes · Hospice Yes
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 174400000X | Specialist | A252550 | CA | Yes |
Practice location
1850 S Waterman AveSuite A
San Bernardino, CA 92408-2852
Phone 909-796-2525 · Fax 909-824-2028
Mailing address
1850 S Waterman AveSuite A
San Bernardino, CA 92408-2852
Phone 909-796-2525 · Fax 909-824-2028
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This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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