Active NPI
Peter Hattar, DMD
- Dentist
- Lake Havasu City, AZ
National Provider Identifier
1831880517
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- D011752
- Practice address
- 211 Swanson Ave
Lake Havasu City, AZ 86403-0926 - Phone
- (928) 854-8540
- NPI assigned
- May 15, 2023
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | D011752 | AZ | Primary |
Addresses
Primary practice location
211 Swanson Ave
Lake Havasu City, AZ 86403-0926
Mailing address
6508 Emmerton LN
Highland, CA 92346-7759
Phone (909) 862-6402
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 |
|---|---|---|---|
| D011752 | AZ | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1684108800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1684108800000",
"number": "1831880517",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6508 EMMERTON LN",
"city": "HIGHLAND",
"state": "CA",
"postal_code": "923467759",
"telephone_number": "909-862-6402"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "211 SWANSON AVE",
"city": "LAKE HAVASU CITY",
"state": "AZ",
"postal_code": "864030926",
"telephone_number": "928-854-8540"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HATTAR",
"first_name": "PETER",
"name_prefix": "Dr.",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2023-05-15",
"last_updated": "2023-05-15",
"certification_date": "2023-05-15",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "AZ",
"license": "D011752",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lake Havasu City, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.