Jessica Hatala, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DS042331 Issued in PA

Practice address

750 Route 739
Lords Valley, PA 18428-6058

Phone

(570) 775-7818

NPI assigned

Jun 9, 2020

Sex

Female

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 PA

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

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

{
    "created_epoch": "1591660800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1595203200000",
    "number": "1972128791",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1239 DUNDAFF ST",
            "city": "DICKSON CITY",
            "state": "PA",
            "postal_code": "185191142",
            "telephone_number": "570-604-2611"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "750 ROUTE 739",
            "city": "LORDS VALLEY",
            "state": "PA",
            "postal_code": "184286058",
            "telephone_number": "570-775-7818"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HATALA",
        "first_name": "JESSICA",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-06-09",
        "last_updated": "2020-07-20",
        "certification_date": "2020-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "PA",
            "license": "DS042331",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tamar R Dresner, CMT
• Diana M Fedorisin, RD, LDN
• Steven L. Follansbee, O.D.
• Pamela Gaeng
• Dong Hun Han
• Helix Healthy Living LCSW PLLC
• Hemlock Farms - Blooming Grove Ambulance
• Tammy Herring, LAC
• Roxanne Nichole Lockwood, PTA
• Lords Valley Dental Care PC

• All providers in Lords Valley, PA
• General Practice Dentistry in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2020; 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.