Walter Gordon Hadley, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

4499 Issued in WA

Practice address

5219 W Clearwater Ave
Kennewick, WA 99336-1914

Phone

(509) 783-7349

Fax

(509) 783-7340

NPI assigned

Mar 26, 2007

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 WA

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

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

{
    "created_epoch": "1174867200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1629196837",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10118 W COURT ST",
            "city": "PASCO",
            "state": "WA",
            "postal_code": "993016506",
            "telephone_number": "509-544-0557",
            "fax_number": "509-735-2675"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5219 W CLEARWATER AVE",
            "city": "KENNEWICK",
            "state": "WA",
            "postal_code": "993361914",
            "telephone_number": "509-783-7349",
            "fax_number": "509-783-7340"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HADLEY",
        "first_name": "WALTER",
        "middle_name": "GORDON",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-26",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WA",
            "license": "4499",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Johanna Haberling-Mansfield, BS, CDP
• Rayel Marie Hacker
• Mahin T Hackler, REGISTERED NURSE
• Vicki Lynn Hackney, RN
• Kay D Hadley, A.R.N.P.
• Marie Haertling
• Kaylee Marie Hagadorn
• Andrew K Hague, AU.D., CCC-A
• Kevin W Hague, M.A., CCC-A
• Bethany Hale, MSW

• General Practice Dentistry in Kennewick, WA
• Providers in Kennewick, WA by specialty
• General Practice Dentistry in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.