Individual provider Active NPI

Dashawn Hatalla, PTA

  • Physical Therapy Assistant
  • Goodyear, AZ
National Provider Identifier
1164339362
Registry record updated Aug 25, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
PTA-015171 Issued in AZ
Practice address
750 N Estrella Pkwy
Goodyear, AZ 85338-9272
Phone
(623) 882-2992
NPI assigned
Aug 25, 2026
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 25, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X PTA-015171 AZ Primary

Addresses

Primary practice location

750 N Estrella Pkwy
Goodyear, AZ 85338-9272

Mailing address

20251 W Tonto St
Buckeye, AZ 85326-8254
Phone (602) 642-9750

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

NPI Registry JSON

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

{
    "created_epoch": "1787616000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787616000000",
    "number": "1164339362",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20251 W TONTO ST",
            "city": "BUCKEYE",
            "state": "AZ",
            "postal_code": "853268254",
            "telephone_number": "602-642-9750"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "750 N ESTRELLA PKWY",
            "city": "GOODYEAR",
            "state": "AZ",
            "postal_code": "853389272",
            "telephone_number": "623-882-2992"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HATALLA",
        "first_name": "DASHAWN",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2026-08-25",
        "last_updated": "2026-08-25",
        "certification_date": "2026-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "AZ",
            "license": "PTA-015171",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Goodyear, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.