Myles Jordan Hastings, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

019.031605 Issued in IL

Practice address

1017 Broadway Ave
Mattoon, IL 61938-4120

Phone

(217) 235-0381

Fax

(217) 235-0396

NPI assigned

Jun 11, 2018

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Hastings Dental Group

  • General Practice Dentistry
  • Mattoon, IL
  • NPI 1760321079
  NPD (past) Authorized official

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

{
    "created_epoch": "1528675200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1528675200000",
    "number": "1285127761",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1017 BROADWAY AVE",
            "city": "MATTOON",
            "state": "IL",
            "postal_code": "619384120",
            "telephone_number": "217-235-0381"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1017 BROADWAY AVE",
            "city": "MATTOON",
            "state": "IL",
            "postal_code": "619384120",
            "telephone_number": "217-235-0381",
            "fax_number": "217-235-0396"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "101 S Vine St Ste 2",
            "address_purpose": "LOCATION",
            "city": "Shelbyville",
            "state": "IL",
            "postal_code": "625651837",
            "country_code": "US",
            "telephone_number": "217-774-2822",
            "fax_number": "217-774-3906",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HASTINGS",
        "first_name": "MYLES",
        "middle_name": "JORDAN",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-06-11",
        "last_updated": "2018-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019.031605",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Morgan Hartke, OTR/L
• Ravishankar Hasanadka, M.D.
• Haley Hasbargen
• Suzanne D Haslett, DDS
• Hastings Dental Group
• Blake Alexander Hawkins
• Jacqueline Hawkins
• Amanda Heath, B.S.
• Lauren Heaton, PT, DPT
• Frances Hebron, RSA

• General Practice Dentistry in Mattoon, IL
• Providers in Mattoon, IL by specialty
• General Practice Dentistry in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2018; 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.