Fawaz Hatem, BDS, MSD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DE.61153474 Issued in WA

Practice address

11540 15TH Ave NE
Seattle, WA 98125-6322

Phone

(206) 440-1500

NPI assigned

Oct 5, 2021

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Networks

• WA PPO C-SNP

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• A Dental & Denture Associates, LLC

  • Denturist
  • Seattle, WA
  • NPI 1861538639
  NPD (past)

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

{
    "created_epoch": "1633392000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754352000000",
    "number": "1053083295",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3608 231ST PL SE",
            "city": "BOTHELL",
            "state": "WA",
            "postal_code": "980216214",
            "telephone_number": "509-539-6475"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11540 15TH AVE NE",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981256322",
            "telephone_number": "206-440-1500"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "19150 NE Woodinville Duvall Rd",
            "address_purpose": "LOCATION",
            "city": "Woodinville",
            "state": "WA",
            "postal_code": "980779477",
            "country_code": "US",
            "telephone_number": "425-788-8900",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HATEM",
        "first_name": "FAWAZ",
        "credential": "BDS, MSD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-10-05",
        "last_updated": "2025-08-05",
        "certification_date": "2025-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "125Q00000X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral Medicine",
            "state": "WA",
            "license": "DENT.DE.61153474",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WA",
            "license": "DE.61153474",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Hatcher Trading PLLC
• Shaka Hatcher, DC
• Tiffany Hatcher
• Hatchmed Corporation
• Celestin Hategeka, MD, PHD
• Edward Elon Hatfield, PA-C
• Emerin Hatfield
• Kevin Hatfield, M.D.
• Michael Hatfield, DDS
• David Swan Hathaway

• General Practice Dentistry in Seattle, WA
• Providers in Seattle, WA by specialty
• General Practice Dentistry in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2025; 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.