Active NPI
Shimaa Hathan
- Dentist
- Gainesville, FL
National Provider Identifier
1922674100
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- DTP821
- Practice address
- 1600 SW Archer Rd # D2-27
Gainesville, FL 32610-0415 - Phone
- (252) 273-7957
- Fax
- (352) 846-1643
- NPI assigned
- May 28, 2021
- Sex
- Female
- Sole proprietor
- Yes
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 | DTP821 | FL | Primary |
Addresses
Primary practice location
1600 SW Archer Rd # D2-27
Gainesville, FL 32610-0415
Mailing address
1600 SW Archer Rd # D2-27
Gainesville, FL 32610-0415
Phone (252) 273-7957
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 |
|---|---|---|---|
| DTP821 | FL | MD | Dentist |
Networks
- Freedom Health HMO Network
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1622160000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1721692800000",
"number": "1922674100",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1600 SW ARCHER RD # D2-27",
"city": "GAINESVILLE",
"state": "FL",
"postal_code": "326100415",
"telephone_number": "252-273-7957",
"fax_number": "352-846-1643"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1600 SW ARCHER RD # D2-27",
"city": "GAINESVILLE",
"state": "FL",
"postal_code": "326100415",
"telephone_number": "252-273-7957",
"fax_number": "352-846-1643"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HATHAN",
"first_name": "SHIMAA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-05-28",
"last_updated": "2024-07-23",
"certification_date": "2024-07-23",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "FL",
"license": "DTP821",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Gainesville, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.