EVAN HATHAWAY DDS PA (NPI# 1215016548) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1215016548 |
| Entity Type | Organization |
| Organization Name | EVAN HATHAWAY DDS PA |
| Other Organization Name | EVAN W HATHAWAY DDS |
| Practice Address |
7677 Emerald St Boise ID 83704 |
| Practice Telephone | 2083771161 |
| Practice Fax Number | 2083763979 |
| Mailing Telephone | 2083771161 |
| Mailing Fax Number | 2083763979 |
| Enumeration Date | 2006-11-06 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | EVAN WAYNE HATHAWAY (PRESIDENT) |
| Authorized Official Telephone | 2083771161 |
| Authorized Official Credential | DDS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 122300000X | Dentist | D2040 | ID | Dental Providers |
| Other Name | Type Code |
|---|---|
| Evan W Hathaway DDS | Former Legal Business Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851552194 | Evan Hathaway Dds Pa | Dentist | 1217 E Iron Eagle Dr, Eagle, ID 83616 | 2008-06-19 |
| Street Address |
7677 EMERALD ST |
| City | BOISE |
| State | ID |
| Zip Code | 83704 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215535893 | Laura Diggs | Counselor | 400 North Benjamin Lane, Suite 200, Boise, ID 83704 | 2020-10-15 |
| 1891304002 | Tree City Family Dental | Dentist | 7301 W. Emerald St Ste. 102, Boise, ID 83704 | 2020-07-24 |
| 1982230710 | Jessica Wynn Councell | Midwife | 1072 N Liberty St Ste 100, Boise, ID 83704 | 2020-03-12 |
| 1699307124 | Isabel Burns Bruce | Registered Nurse | 777 N Raymond Street, Boise, ID 83704 | 2020-02-12 |
| 1558903328 | Daring In Idaho, LLC | Social Worker | 413 N Allumbaugh Street, Suite 102, Boise, ID 83704 | 2019-10-14 |
| 1053960286 | Kyle Hiromi Hatanaka | Acupuncturist | 9450 #120 Fairview Avenue, Boise, ID 83704 | 2019-09-10 |
| 1700447141 | Katie Elizabeth Nichols | Physician Assistant | 1072 N Liberty St Ste 201, Boise, ID 83704 | 2019-06-26 |
| 1588164727 | Cory Michael Sims | Counselor | 6550 W. Emerald St #112, Boise, ID 83704 | 2018-02-14 |
| 1477072270 | Matthew Lee Love | Non-emergency Medical Transport (VAN) | 6933 W. Stratton St, Boise, ID 83704 | 2017-09-12 |
| 1942735949 | Dalana Sue Thompson | Counselor | 9196 Emerald St Suite #130, Boise, ID 83704 | 2017-04-27 |
| Find all providers in zip 83704 | ||||
| Taxonomy Code | 122300000X |
| Grouping | Dental Providers |
| Classification | Dentist |
| 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. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891304002 | Tree City Family Dental | Dentist | 7301 W. Emerald St Ste. 102, Boise, ID 83704 | 2020-07-24 |
| 1093369241 | Daniel Bryan Ackerman | Dentist | 10200 W Emerald St Ste 105, Boise, ID 83704-8900 | 2019-07-26 |
| 1497105944 | Carson Steven Dial | Dentist | 1529 S Timesquare Ln Ste 100, Boise, ID 83709-8204 | 2016-06-15 |
| 1538563044 | Smiles 4 Kids | Dentist | 5737 W Fairview Ave, Boise, ID 83706-1168 | 2014-10-13 |
| 1407260128 | David A Luker | Dentist | 514 S El Blanco Dr, Boise, ID 83709-0444 | 2014-06-20 |
| 1841626710 | Stephen Anthony Hubert | Dentist | 600 E. Riverpark Ln., Ste. 100, Boise, ID 83706-7237 | 2013-09-23 |
| 1215360292 | William Blake Bybee | Dentist | 5833 W. Hidden Springs Dr., Boise, ID 83714 | 2013-08-14 |
| 1346689866 | Boise Towne Square Dental | Dentist | 7677 W. Emerald, Boise, ID 83704 | 2013-06-18 |
| 1396183976 | Anne K. Steinberg, Dmd, P. C. | Dentist | 1410 S Entertainment Ave, Boise, ID 83709-8306 | 2013-06-05 |
| 1912344284 | David Norman Wold | Dentist | 8950 W Emerald St Ste 108, Boise, ID 83704 | 2013-05-28 |
| Find all providers in BOISE | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.