Amelya R. Hardaway, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

DN014519 Issued in GA

Practice address

1721 Powder Springs Rd SW Ste 103
Coast Dental - Cheatham Hill
Marietta, GA 30064-4880

Phone

(770) 293-0605

Fax

(770) 293-0606

NPI assigned

May 4, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1178236800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1416355200000",
    "number": "1184836744",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2595 CENTRAL AVE",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381045905",
            "telephone_number": "901-260-8551",
            "fax_number": "901-260-8590"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1721 POWDER SPRINGS RD SW STE 103",
            "address_2": "COAST DENTAL - CHEATHAM HILL",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300644880",
            "telephone_number": "770-293-0605",
            "fax_number": "770-293-0606"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARDAWAY",
        "first_name": "AMELYA",
        "middle_name": "R.",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-04",
        "last_updated": "2014-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "23126",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TN",
            "license": "9061",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "GA",
            "license": "DN014519",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1516040",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Michele Harbeson, BS, DC
• Jennifer Harbin, MS, LPC, NCC
• Spencer Raymond Harden, DDS
• Stevie Harden II
• Christopher Hardin
• Heather Smith Hardison, NP-C
• George Steve Hardman, CRNA

• All providers in Marietta, GA
• Dentist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.