Mary Laura Hastings, DMD

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

34369 Issued in TX

Practice address

1701 Moores Lane
Texarkana, TX 75503

Phone

(903) 794-3331

Fax

(903) 793-7217

NPI assigned

Mar 26, 2012

Last updated

Jul 8, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Feb 10, 2020 through Feb 10, 2028

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.

• Oral and Maxillofacial Surgeons of Northeast Texas, P. a.

  • Oral and Maxillofacial Surgery (Dentist)
  • Texarkana, TX
  • NPI 1902052095
  NPD (past)
• Oral and Maxillofacial Surgeons of Northeast Texas, PLLC

  • Oral and Maxillofacial Surgery (Dentist)
  • Texarkana, TX
  • NPI 1538560362
  NPD (past)

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

{
    "created_epoch": "1332720000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657238400000",
    "number": "1710253539",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1701 MOORES LANE",
            "city": "TEXARKANA",
            "state": "TX",
            "postal_code": "75503",
            "telephone_number": "903-794-3331",
            "fax_number": "903-793-7217"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1701 MOORES LANE",
            "city": "TEXARKANA",
            "state": "TX",
            "postal_code": "75503",
            "telephone_number": "903-794-3331",
            "fax_number": "903-793-7217"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HASTINGS",
        "first_name": "MARY",
        "middle_name": "LAURA",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-03-26",
        "last_updated": "2022-07-08",
        "certification_date": "2022-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "TX",
            "license": "34369",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• John J Harris, M.D.
• Samantha Lee Harris, APRN
• John Benjamin Harrison, APRN
• Glen Woodford Hart II, O.D.
• Cynthia Hash
• Hatel Sanjay Patel PA
• Savannah Layne Terry Hatfield, COTA
• Allen V Havener, MD
• Megan Hawley
• Bess C Hawthorne, COTA

• Oral and Maxillofacial Surgery (Dentist) in Texarkana, TX
• Providers in Texarkana, TX by specialty
• Oral and Maxillofacial Surgery (Dentist) in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2022; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.