Active NPI
David L Hatch, DMD
- Endodontics
- Festus, MO
National Provider Identifier
1700401577
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Endodontics
- License
- 2020013626
- Practice address
- 1321 Veterans Blvd
Festus, MO 63028-2329 - Phone
- (636) 931-4020
- NPI assigned
- Jun 8, 2020
- Last updated
- Jul 8, 2020
- 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 |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 2020013626 | MO | |
| Endodontics | 1223E0200X | 2020013626 | MO | Primary |
Addresses
Primary practice location
1321 Veterans Blvd
Festus, MO 63028-2329
Mailing address
1321 Veterans Blvd
Festus, MO 63028-2329
Phone (636) 931-4020
Other practice location 1
4121 Union Rd Ste 215
Saint Louis, MO 63129-1070
Phone (314) 894-5600
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 |
|---|---|---|---|
| 2020013626 | MO | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| C. W. Clarke DDS PC | Past | Accepting new patients |
Interoperability endpoints
- david.hatch.p1@direct.affiniahealthcare.nextgenshare.com
Organizations & group practices 1
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1591574400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1594166400000",
"number": "1700401577",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1321 VETERANS BLVD",
"city": "FESTUS",
"state": "MO",
"postal_code": "630282329",
"telephone_number": "636-931-4020"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1321 VETERANS BLVD",
"city": "FESTUS",
"state": "MO",
"postal_code": "630282329",
"telephone_number": "636-931-4020"
}
],
"practiceLocations": [
{
"address_1": "4121 Union Rd Ste 215",
"address_purpose": "LOCATION",
"city": "Saint Louis",
"state": "MO",
"postal_code": "631291070",
"country_code": "US",
"telephone_number": "314-894-5600",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "HATCH",
"first_name": "DAVID",
"middle_name": "L",
"name_prefix": "Dr.",
"credential": "DMD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2020-06-08",
"last_updated": "2020-07-08",
"certification_date": "2020-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "MO",
"license": "2020013626",
"primary": false
},
{
"code": "1223E0200X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Dentist, Endodontics",
"state": "MO",
"license": "2020013626",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Festus, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.