Physician Compare National (NPI:1538193370)

HEALTHCARE PROVIDER: JOHN JOSEPH HILLGEN IV D.M.D.

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1538193370
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	1557457702
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20071018000661
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	HILLGEN
	Individual professional last name
Provider First Name	JOHN
	Individual professional first name
Provider Name Suffix Text	IV
	The name suffix of the provider if the provider is an individual. The name suffix is a ''generation-related'' suffix, such as Jr., Sr., II, III, IV, or V.
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	OTHER
	Individual professional's medical school
Graduation Year	1995
	Individual professional's medical school graduation year
Primary Specialty	ORAL SURGERY
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Organization Legal Name	GREATER WATERBURY ORAL AND MAXILLOFACIAL SURGEONS LLC
	Legal name of the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Group Practice PAC ID	8921194168
	Unique Group Practice ID assigned by PECOS to the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Number of Group Practice members	2
	Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address	1389 W MAIN ST
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE 320
	Group Practice or individual's line 2 address
City	WATERBURY
	Group Practice or individual's city
State	CT
	Group Practice or individual's state
Zip Code	067083104
	Group Practice or individual's zip code (9 digits when available)
Phone Number	2035731427
	Phone number is listed only when there is a single phone number available for the practice location address

Hospital(s) Affiliation Information
Professional Accepts Medicare Assignment	M