Fadi Jamil Hawwash, DMD

Primary specialty

DentistTaxonomy code 122300000X

License

016-0002104 Issued in VT

Practice address

130 Birge St
130 Birge Street
Brattleboro, VT 05301-6460

Phone

(802) 251-1031

Fax

(802) 251-0022

NPI assigned

Oct 19, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in VT

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": "1161216000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1669554945",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "130 BIRGE ST",
            "address_2": "130 BIRGE STREET",
            "city": "BRATTLEBORO",
            "state": "VT",
            "postal_code": "053016460",
            "telephone_number": "802-251-1031",
            "fax_number": "802-251-0022"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 BIRGE ST",
            "address_2": "130 BIRGE STREET",
            "city": "BRATTLEBORO",
            "state": "VT",
            "postal_code": "053016460",
            "telephone_number": "802-251-1031",
            "fax_number": "802-251-0022"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAWWASH",
        "first_name": "FADI",
        "middle_name": "JAMIL",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-19",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "VT",
            "license": "016-0002104",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1007509",
            "state": "VT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Bruce B Hart, LADC
• Jennifir Bailes Hart, LCMHC
• Edward M Harty
• Kimi Hasegawa, P.T.
• Megan Schwarz Hawthorne, LICSW
• Anne H Haydock, MD
• Ethan Hazzard-Watkins
• Health Care & Rehabilitation Services of SE VT Inc.
• Healthy Homes of New England
• Michaela Emily Hearst, LICSW

• Dentist in Brattleboro, VT
• Providers in Brattleboro, VT by specialty
• Dentist in Vermont

• 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.