Individual provider Active NPI

Jeremy L Hawkins, DDS, PHARMD

  • Dentist
  • Eden, NC
National Provider Identifier
1104052638
Registry record updated Jun 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
14271 Issued in NC
Practice address
113 W Arbor LN
Eden, NC 27288-5305
Phone
(336) 623-9143
Fax
(336) 627-0948
NPI assigned
Jun 10, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 25, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 16461 NC
Dentist 122300000X 14271 NC Primary

Addresses

Primary practice location

113 W Arbor LN
Eden, NC 27288-5305

Mailing address

PO Box 929
Eden, NC 27289-0929
Phone (336) 623-9143

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
Credentials
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
16461NCMDPhysical Therapist
14271NCMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Abbey S. Hawkins, DDS, PA CurrentSince Jun 29, 2025 Accepting new patients

Locations

113 W Arbor Ln
Eden, NC 27288
Phone (336) 623-9143

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1244592000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750809600000",
    "number": "1104052638",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 929",
            "city": "EDEN",
            "state": "NC",
            "postal_code": "272890929",
            "telephone_number": "336-623-9143",
            "fax_number": "336-627-0948"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "113 W ARBOR LN",
            "city": "EDEN",
            "state": "NC",
            "postal_code": "272885305",
            "telephone_number": "336-623-9143",
            "fax_number": "336-627-0948"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAWKINS",
        "first_name": "JEREMY",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "DDS, PHARMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-06-10",
        "last_updated": "2025-06-25",
        "certification_date": "2025-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NC",
            "license": "16461",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NC",
            "license": "14271",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Eden, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 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.