Michael John Hawley, DDS MS

Primary specialty

DentistTaxonomy code 122300000X

License

D0515 Issued in SD

Practice address

600 4TH St NE Suite 101
Watertown, SD 57201

Phone

(605) 878-0180

Fax

(605) 878-0181

NPI assigned

Jan 17, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in SD

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

Credentials

Master of Science

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Prairie Ridge Endodontics LLC

  • Endodontics
  • Watertown, SD
  • NPI 1336866557
  NPD (past)

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

{
    "created_epoch": "1137456000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1565913600000",
    "number": "1891775904",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 4TH ST NE SUITE 101",
            "city": "WATERTOWN",
            "state": "SD",
            "postal_code": "57201",
            "telephone_number": "605-878-0180",
            "fax_number": "605-878-0181"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 4TH ST NE SUITE 101",
            "city": "WATERTOWN",
            "state": "SD",
            "postal_code": "57201",
            "telephone_number": "605-878-0180",
            "fax_number": "605-878-0181"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAWLEY",
        "first_name": "MICHAEL",
        "middle_name": "JOHN",
        "name_prefix": "Dr.",
        "credential": "DDS MS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-01-17",
        "last_updated": "2019-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "SD",
            "license": "D0515",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Farah N Haque, M.D.
• Mackenzie Hardie, PT
• Nicholas John Harms, M.D.
• Kimberly A Haugen, PHD
• Gwen Louise Hawley Holinka, OTR/L
• Stephanie Hayunga, OTR/L
• Heal Harbor LLC
• Healthfirst Chiropractic of Watertown
• Healthfirst Chiropractic of Watertown
• Heartland Dermatology

• Dentist in Watertown, SD
• Providers in Watertown, SD by specialty
• Dentist in South Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2019; 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.