MARK P HATALA (NPI# 1669559159) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1669559159 |
| Entity Type | Individual |
| Full Name | MARK P HATALA |
| Credential | DDS |
| Practice Address |
165 Riverside Drive Johnson City NY 13790 |
| Practice Telephone | 6076449100 |
| Practice Fax Number | 6076449113 |
| Mailing Telephone | 6076449100 |
| Mailing Fax Number | 6076449113 |
| Enumeration Date | 2006-11-01 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223X0400X |
Dentist Specialization: Orthodontics and Dentofacial Orthopedics |
041662 | NY | Dental Providers |
| Street Address |
165 RIVERSIDE DRIVE |
| City | JOHNSON CITY |
| State | NY |
| Zip Code | 13790 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578107645 | Thomas William Sorber | Occupational Therapist | 33 Harrison St, Johnson City, Johnson City, NY 13790 | 2019-11-01 |
| 1326534116 | Silver Linings Golden Memory Care | Clinic/Center | 4416 Watson Blvd, Johnson City, NY 13790 | 2018-07-05 |
| 1508308545 | Irene Mukeli Nzasi | Registered Nurse | 156 Corliss Ave Suite 107, Johnson City, NY 13790 | 2016-11-08 |
| 1053867754 | Tabitha Rae Toman | Physical Therapist | 34 Harrison St, Johnson City, NY 13790 | 2016-09-01 |
| 1235685066 | Dianne Brunner | Physical Therapist | 33-55 Harrison Street, Wilson Hospital, Johnson City, NY 13790 | 2016-08-31 |
| 1578982682 | Tracy Lynn Brown | Optometrist | 223 Reynolds Road, Johnson City, NY 13790 | 2014-04-16 |
| 1083041495 | Maryann Serbonich | Pharmacist | 52 Harrison Street, Johnson City, NY 13790 | 2013-09-30 |
| 1134464399 | Kasey Connor Folger | Speech-Language Pathologist | 3 Laurel St., Johnson City, NY 13790 | 2012-11-29 |
| 1467797571 | Bodyworks Physical Therapy LLC | Clinic/Center | 765 Harry L Drive, Johnson City, NY 13790 | 2012-11-29 |
| 1548518400 | Melissa L Korosec | Nurse Practitioner | 30 Harrison St., Suite 250, Johnson City, NY 13790 | 2012-08-27 |
| Find all providers in zip 13790 | ||||
| Taxonomy Code | 1223X0400X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Orthodontics and Dentofacial Orthopedics |
| That area of dentistry concerned with the supervision, guidance and correction of the growing or mature dentofacial structures, including those conditions that require movement of teeth or correction of malrelationships and malformations of their related structures and the adjustment of relationships between and among teeth and facial bones by the application of forces and/or the stimulation and redirection of functional forces within the craniofacial complex. Major responsibilities of orthodontic practice include the diagnosis, prevention, interception and treatment of all forms of malocclusion of the teeth and associated alterations in their surrounding structures; the design, application and control of functional and corrective appliances; and the guidance of the dentition and its supporting structures to attain and maintain optimum occlusal relations in physiologic and esthetic harmony among facial and cranial structures. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619595618 | Allison Jerri Williams | Dentist | 801 Sunset Dr # E5, Johnson City, TN 37604-3033 | 2020-07-07 |
| 1316334071 | John Marshall Jewett | Dentist | 2333 Knob Creek Rd Ste 10, Johnson City, TN 37604 | 2015-04-21 |
| 1568884393 | Walter Harber | Dentist | 111 Ridgemont Rd, Johnson City, TN 37601-3939 | 2014-01-14 |
| 1295812782 | Hatala Orthodontics PC | Dentist | 165 Riversidedrive, Johnson City, NY 13790 | 2006-11-01 |
| 1487764049 | Orthodontic Associates, Plc | Dentist | 801 Sunset Dr Bldg E # 5, Johnson City, TN 37604-3033 | 2006-08-30 |
| 1235142282 | John W Bradshaw | Dentist | 189 Corporate Dr Ste 30, Johnson City, TN 37604-2386 | 2006-08-14 |
| 1497318471 | John Marshall Jewett Dmd Pllc | Dentist | 2333 Knob Creek Rd Ste 10, Johnson City, TN 37604-2007 | 2019-04-16 |
| 1497085435 | Daniel Mcclaskey Auter | Dentist | 508 Princeton Rd, Suite 305, Johnson City, TN 37601-2060 | 2010-01-13 |
| 1487782652 | Leighton W Wood Dds, M.s., PC | Dentist | 2333 Knob Creek Rd, Ste 10, Johnson City, TN 37604-2007 | 2007-03-01 |
| 1790881233 | Drs. Bradshaw and Hathaway | Dentist | 300 W Watauga Ave, Johnson City, TN 37604-5549 | 2006-09-15 |
| Find all providers in JOHNSON CITY | ||||
| City | JOHNSON CITY |
| Zip Code | 13790 |
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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.