Jon Riley Hastings, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

3254 Issued in IL

Practice address

1529 S Timesquare LN
Boise, ID 83709-8266

Phone

(208) 343-1981

Fax

(208) 672-9067

NPI assigned

Aug 3, 2006

Last updated

Jul 9, 2007By the provider in NPPES

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

Enrolled in ID

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Times Square Dental

  • General Practice Dentistry
  • Boise, ID
  • NPI 1942469713
  NPD (past) Authorized official
• Times Square Dental

  • General Practice Dentistry
  • Boise, ID
  • NPI 1013831775
  NPD (past)

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

{
    "created_epoch": "1154563200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1457369746",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1529 S. TIMES SQUARE CRT,",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "83709",
            "telephone_number": "208-343-1981",
            "fax_number": "208-672-9067"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1529 S TIMESQUARE LN",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837098266",
            "telephone_number": "208-343-1981",
            "fax_number": "208-672-9067"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HASTINGS",
        "first_name": "JON",
        "middle_name": "RILEY",
        "name_prefix": "Mr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-03",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "3254",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lora R Hasse, LCPC
• Julia Hassell, ATC, OTC
• David E Hassinger, MD
• Sean Hassinger, MD
• Brittany Marie Hassis, LPC
• Justin Hastings, DDS, MD
• Aimee Lynn Hastriter, DNP, CPNP
• Christine E. Hatab, PT
• Kyle Hiromi Hatanaka, LAC
• Matthew Hatch

• General Practice Dentistry in Boise, ID
• Providers in Boise, ID by specialty
• General Practice Dentistry in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; 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.