Evan Hathaway, DDS
Dentist · Eagle, ID
Practice location
1217 E Iron Eagle DrEagle, ID 83616-6599
- Phone
- (208) 377-1161
- Fax
- (208) 938-0567
NPI record
- NPI
- 1033455019
- Entity type
- Individual (Type 1)
- Enumeration date
- December 20, 2012
- Last updated
- December 20, 2012
- Sole proprietor
- Yes
Specialties & taxonomy codes
| Taxonomy | Code | License | State |
|---|---|---|---|
| Dentist Primary | 122300000X |
D2040 | ID |
About Dr. Hathaway
Evan Hathaway, DDS is a healthcare provider registered in the NPI registry with the primary taxonomy Dentist (code 122300000X). The practice location is 1217 E Iron Eagle Dr, Eagle, ID 83616-6599. The NPI number 1033455019 was assigned on December 20, 2012 and the record was last updated on December 20, 2012.
Dr. Hathaway lists a license in the registry: #D2040 (ID) for Dentist. License numbers are self-reported to NPPES; verify them with the state licensing board.
Frequently asked questions
What is the NPI number of Evan Hathaway, DDS?
The NPI number is 1033455019.
What is the phone number of Dr. Hathaway?
The phone number listed for the practice location is (208) 377-1161.
Where is Dr. Hathaway located?
1217 E Iron Eagle Dr, Eagle, ID 83616-6599.
What is the taxonomy code for Dr. Hathaway?
The primary taxonomy code is 122300000X – Dentist.
Is this information correct?
All details come from the public NPPES registry. Providers can update their record at nppes.cms.hhs.gov; changes appear here after the next weekly update.
Other Dentist providers in Eagle
- Lighthouse Dental Group1177 N Eagle Rd
- Eagle Natural Dentistry LLC700 E State St Ste 100
- Greg Ron Davis, D.D.S467 S Rivershore Ln
- Evan Hathaway DDS PA1217 E Iron Eagle Dr
- Christian Putegnat1217 E Iron Eagle Dr
- Caleb Edward Stott, DMD467 S. Rivershore Lane