Jennifer a Hathaway DDS PA

Primary specialty

Customized Equipment (DME)Taxonomy code 332BC3200X

Legal business name

JENNIFER A HATHAWAY DDS PA

Practice address

1719 Broadmoor Dr
Bryan, TX 77802-5210

Phone

(979) 776-6884

Fax

(979) 774-3008

NPI assigned

Mar 12, 2020

Organization subpart

No

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

Authorized official

Name

Mrs. Stevie Fester, RDA

Title

Practice Manager

Phone

(979) 776-6884

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jennifer Ann Hathaway, D.D.S.

  • General Practice Dentistry
  • Bryan, TX
  • NPI 1477558815
  NPD

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

{
    "created_epoch": "1583971200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1679356800000",
    "number": "1972139764",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1719 BROADMOOR DR",
            "city": "BRYAN",
            "state": "TX",
            "postal_code": "778025210",
            "telephone_number": "979-776-6884",
            "fax_number": "979-774-3008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1719 BROADMOOR DR",
            "city": "BRYAN",
            "state": "TX",
            "postal_code": "778025210",
            "telephone_number": "979-776-6884",
            "fax_number": "979-774-3008"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JENNIFER A HATHAWAY DDS PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-03-12",
        "last_updated": "2023-03-21",
        "certification_date": "2023-03-21",
        "status": "A",
        "authorized_official_last_name": "FESTER",
        "authorized_official_first_name": "STEVIE",
        "authorized_official_title_or_position": "PRACTICE MANAGER",
        "authorized_official_telephone_number": "979-776-6884",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "RDA"
    },
    "taxonomies": [
        {
            "code": "332BC3200X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Customized Equipment",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "mysecureemail.com",
            "affiliation": "N",
            "endpointDescription": "secure email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1719 Broadmoor Dr",
            "city": "Bryan",
            "state": "TX",
            "country_code": "US",
            "postal_code": "778025210",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Lynda Lizbeth Jarrell
• Ires Joy Jawod
• Barbara Jeffers, RN
• Teresa Jenkins
• Terry R Jenkins, M.D.
• Jennifer L. Rockett, PH.D.
• Tanner Jennings, DO
• Erik Jensen, MA, LPC
• John Charles Jentsch, PT, DPT
• Erin Rutledge Jereb, M.S.

• Customized Equipment (DME) in Bryan, TX
• Providers in Bryan, TX by specialty
• Customized Equipment (DME) in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.