Hathaway and Pelletier Family Dental PLLC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

HATHAWAY AND PELLETIER FAMILY DENTAL PLLC

Practice address

1217 E Iron Eagle Dr
Eagle, ID 83616-6599

Phone

(208) 377-1161

Fax

(208) 938-0567

NPI assigned

Nov 12, 2020

Last updated

Nov 12, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Benjamin E Tuinei

Title

Credentialing Manager

Phone

(602) 750-6897

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1605139200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1605139200000",
    "number": "1790387959",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1217 E IRON EAGLE DR",
            "city": "EAGLE",
            "state": "ID",
            "postal_code": "836166599",
            "telephone_number": "208-377-1161",
            "fax_number": "208-938-0567"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1217 E IRON EAGLE DR",
            "city": "EAGLE",
            "state": "ID",
            "postal_code": "836166599",
            "telephone_number": "208-377-1161",
            "fax_number": "208-938-0567"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HATHAWAY AND PELLETIER FAMILY DENTAL PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-11-12",
        "last_updated": "2020-11-12",
        "certification_date": "2020-11-12",
        "status": "A",
        "authorized_official_last_name": "TUINEI",
        "authorized_official_first_name": "BENJAMIN",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "CREDENTIALING MANAGER",
        "authorized_official_telephone_number": "602-750-6897"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Matthew Hargis, RN
• Rachel Harrington
• Michele Harris, LCPC, M.ED
• Hartford Healthcare Homecare and Hospice LLC
• Hartford Healthcare Homecare and Hospice LLC
• Evan Hathaway, DDS
• Kaitlyndawn Haynes
• Health Services Seattle LLC (Miracle Ear)
• Healthy Alignment Chiropractic PLLC
• Ryan Heilman, DPT

• Dental Clinic/Center in Eagle, ID
• Providers in Eagle, ID by specialty
• Dental Clinic/Center in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 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.

Verify at the official NPI Registry.