Individual provider Active NPI

Alesia Hatten, D.D.S.

  • Dentist
  • Fort Leonard Wood, MO
National Provider Identifier
1174932271
Registry record updated Aug 4, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
2014018760 Issued in MO
Practice address
6958 Nebraska Ave
Fort Leonard Wood, MO 65473-1618
Phone
(573) 596-0411
Fax
(573) 596-0410
NPI assigned
Aug 4, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 4, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 9874 TN
Dentist 122300000X 2014018760 MO Primary

Addresses

Primary practice location

6958 Nebraska Ave
Fort Leonard Wood, MO 65473-1618

Mailing address

24180 Tanglewood Rd
Saint Robert, MO 65584-3815
Phone (601) 212-5375

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

LicenseStateTypeSpecialty
2014018760MOMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1407110400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1407110400000",
    "number": "1174932271",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24180 TANGLEWOOD RD",
            "city": "SAINT ROBERT",
            "state": "MO",
            "postal_code": "655843815",
            "telephone_number": "601-212-5375",
            "fax_number": "601-212-5375"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6958 NEBRASKA AVE",
            "city": "FORT LEONARD WOOD",
            "state": "MO",
            "postal_code": "654731618",
            "telephone_number": "573-596-0411",
            "fax_number": "573-596-0410"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HATTEN",
        "first_name": "ALESIA",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-08-04",
        "last_updated": "2014-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TN",
            "license": "9874",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MO",
            "license": "2014018760",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Leonard Wood, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2014; 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.