Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

DR. STEFAN SHANE HACKER DDS
NPI 1114916244
Dentist in Jay, OK

Q: What is Stefan Hacker's NPI number?

The NPI number for Stefan Hacker is 1114916244. It was assigned to this individual provider in the NPPES registry on October 20, 2005.

Q: What is Stefan Hacker's specialty?

The primary specialty registered for this NPI is Dentist with taxonomy code 122300000X.

Q: When was this NPI record last updated?

The NPPES record for Stefan Hacker was last updated on July 13, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 32 days ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since October 20, 2005PECOS Enrolled

1015 W WASHBOURNE ST, JAY, OK 74346(918) 253-8696 Get Directions Write a Review

NPPES record last updated: July 13, 2026. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Jul 13, 2026, May 19, 2016 (2 updates tracked since 2016).

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About Dr. Stefan Shane Hacker Dds NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. STEFAN SHANE HACKER DDS (NPI 1114916244) is an individual dentist in Jay, Oklahoma, licensed in Oklahoma (5354) and active in the NPI registry since October 2005. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1114916244

Entity TypeIndividualMale

Primary Taxonomy122300000X

Provider Legal NameDR. STEFAN SHANE HACKERCredential: DDS

Location Address1015 W WASHBOURNE STJay, OK 74346-4205

Mailing Address200 E 3rd StGrove, OK 74344-7006 · (918) 787-7900

Phone(918) 253-8696

Sole ProprietorNo

Enumeration DateOctober 20, 2005

Last NPPES UpdateJuly 13, 20262 updates tracked since enumeration

✔ NPI 1114916244 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentistDental Providers

Taxonomy Code122300000X

License✔ Licensed in OK · 5354

Definition

A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist.

1015 W WASHBOURNE ST, Jay, OK 74346

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma, Blue Cross and Blue Shield of Texas.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Stefan Shane Hacker Dds is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 74346 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$82.46 typical visit price

range $53.00 – $162.61

Typical copayment $20.61 (range $13.25 – $40.65)

Most-billed visit code 99203

Established Patient

$66.48 typical visit price

range $16.68 – $132.40

Typical copayment $16.62 (range $4.17 – $33.10)

Most-billed visit code 99213

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

TRAVIS VIRON KERSH

Peer Specialist