Anthony J Hathaway DDS PC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

07404 Issued in IA

Legal business name

ANTHONY J HATHAWAY DDS PC

Practice address

1333 W Lombard St
Davenport, IA 52804-2101

Phone

(563) 323-9331

NPI assigned

Oct 25, 2006

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Anthony J Hathaway, D.D.S., P.C.NPI 1134307416

Title

Owner

Phone

(563) 323-9331

Specialties & licenses 1

Addresses

Other identifiers 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Anthony J Hathaway, DDS

  • Dentist
  • Davenport, IA
  • NPI 1134307416
  Authorized official Same address or phone

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1161734400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1013092667",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1333 W LOMBARD ST",
            "city": "DAVENPORT",
            "state": "IA",
            "postal_code": "528042101",
            "telephone_number": "563-323-9331"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1333 W LOMBARD ST",
            "city": "DAVENPORT",
            "state": "IA",
            "postal_code": "528042101",
            "telephone_number": "563-323-9331"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANTHONY J HATHAWAY DDS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-25",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "HATHAWAY",
        "authorized_official_first_name": "ANTHONY",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "563-323-9331",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S., P.C."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IA",
            "license": "07404",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1057968",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Apac Customer Services, Inc. (Medco)

• General Practice Dentistry in Davenport, IA
• Providers in Davenport, IA by specialty
• General Practice Dentistry in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.