Active NPI
Samuel Hawkins
- Dentist
- Reading, PA
National Provider Identifier
1245976125
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- DS043751
- Practice address
- 3302 N 5TH Street Hwy
Reading, PA 19605-2427 - Phone
- (814) 715-6169
- NPI assigned
- May 12, 2022
- Last updated
- Sep 19, 2022
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | DS043751 | PA | Primary |
| Student in an Organized Health Care Education/Training Program | 390200000X | NU |
Addresses
Primary practice location
3302 N 5TH Street Hwy
Reading, PA 19605-2427
Mailing address
2004 Arch Street Ext
Brockway, PA 15824-8018
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 |
|---|---|---|---|
| DS043751 | PA | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1652313600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1663545600000",
"number": "1245976125",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2004 ARCH STREET EXT",
"city": "BROCKWAY",
"state": "PA",
"postal_code": "158248018"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3302 N 5TH STREET HWY",
"city": "READING",
"state": "PA",
"postal_code": "196052427",
"telephone_number": "814-715-6169"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HAWKINS",
"first_name": "SAMUEL",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2022-05-12",
"last_updated": "2022-09-19",
"certification_date": "2022-09-19",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "PA",
"license": "DS043751",
"primary": true
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": "NU",
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Reading, PA
- Christina Hauze
- Haven Behavioral Services of Reading, LLC (Haven Behavioral Hospital of Eastern Pennsylvania)
- Haven Behavioral Services of Reading, LLC (Haven Behavioral Hospital of Eastern Pennsylvania)
- Haven Behavioral Services Or Reading, LLC (Haven Behavioral Hospital of Eastern Pennsylvania Outpatient)
- Elizabeth Hawk, MS, RD, LDN
- Donna Hayden
- Arleen G Haynes, M.D.
- Marihelene Haynes, M.ED., MBA
- Kamaleddin Hazaveh, DMD
- Healing Heartspa (Healing Hearts HomecarePA)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.