Active NPI
Brian James Hathcoat, DDS
- Dentist
- Martinez, CA
National Provider Identifier
1083962492
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 61544
- Practice address
- 2500 Alhambra Ave
Martinez, CA 94553-3156 - Phone
- (925) 370-5110
- Fax
- (925) 370-5142
- NPI assigned
- Aug 16, 2012
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 61544 | CA | Primary |
Addresses
Primary practice location
2500 Alhambra Ave
Martinez, CA 94553-3156
Mailing address
17051 Broadway Ter
Oakland, CA 94611-1032
Phone (925) 313-6098
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 61544 | CA | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1345075200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1579564800000",
"number": "1083962492",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "17051 BROADWAY TER",
"city": "OAKLAND",
"state": "CA",
"postal_code": "946111032",
"telephone_number": "925-313-6098",
"fax_number": "925-313-6599"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2500 ALHAMBRA AVE",
"city": "MARTINEZ",
"state": "CA",
"postal_code": "945533156",
"telephone_number": "925-370-5110",
"fax_number": "925-370-5142"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HATHCOAT",
"first_name": "BRIAN",
"middle_name": "JAMES",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2012-08-16",
"last_updated": "2020-01-21",
"certification_date": "2020-01-21",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "CA",
"license": "61544",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Martinez, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 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.