DR. JENNIFER ANN HATHAWAY (NPI# 1477558815) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1477558815 |
| Entity Type | Individual |
| Full Name | DR. JENNIFER ANN HATHAWAY |
| Credential | D.D.S. |
| Practice Address |
1719 Broadmoor Dr Bryan TX 77802-5210 |
| Practice Telephone | 9797766884 |
| Practice Fax Number | 9797743008 |
| Mailing Telephone | 9797766884 |
| Mailing Fax Number | 9797743008 |
| Enumeration Date | 2005-06-14 |
| Last Update Date | 2020-03-12 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
17025 | TX | Dental Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467957555 | Jennifer Hathaway | Nurse Practitioner | 1175 S Perry St Ste 200, Castle Rock, CO 80104-0015 | 2018-03-29 |
| 1225425887 | Jennifer Hathaway | Physical Therapist | 15 Parkman St, Wang Ambulatory Care Center, Room 128, Boston, MA 02114-3117 | 2015-04-22 |
| Street Address |
1719 BROADMOOR DR |
| City | BRYAN |
| State | TX |
| Zip Code | 77802-5210 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972139764 | Jennifer A Hathaway Dds Pa | Durable Medical Equipment & Medical Supplies | 1719 Broadmoor Dr, Bryan, TX 77802-5210 | 2020-03-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013476951 | Andrea Pittman | Student in an Organized Health Care Education/Training Program | Primary Care Medicine Department, College of Medicine, 2900 East 29th Street, Bryan, TX 77802 | 2019-03-19 |
| 1942789110 | Alicia Diane Ates | Dentist | 3001 Wildflower Drive, Suite #511, Bryan, TX 77802 | 2018-08-09 |
| 1588151682 | Metx LLC | Audiologist-Hearing Aid Fitter | 3030 E 29th St Ste 102, Bryan, TX 77802 | 2018-04-16 |
| 1073047437 | Abbi Messer | Family Medicine | 2900 29th Street, Suite 100, Bryan, TX 77802 | 2017-04-12 |
| 1265885180 | Scott Andrew Thayer | Dentist | 3811 Stoneparc Dr, Bryan, TX 77802 | 2016-07-15 |
| 1255792123 | Phoebe Mathew | Pharmacist | 3312 East 29th Street, Bryan, TX 77802 | 2016-03-18 |
| 1801253810 | Pearl Coleshill | Specialist/Technologist | 3121 University Drive E., Suite 100, Bryan, TX 77802 | 2016-01-21 |
| 1265847750 | Wesley Danielle Daniels | Dietitian, Registered | 3900-c Carter Creek Pkway, Bryan, TX 77802 | 2014-06-24 |
| 1235549098 | Regina V. Robertson | Home Health | 1121 Briarcrest Dr., Suite 102, Bryan, TX 77802 | 2014-05-02 |
| 1982024238 | Lampstand Nursing and Rehabilitation, Lp | Skilled Nursing Facility | 2001 E 29th Street, Bryan, TX 77802 | 2014-04-24 |
| Find all providers in zip 77802 | ||||
| Taxonomy Code | 1223G0001X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | General Practice |
| A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. |
| Notes: Source: Academy of General Dentistry |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205453883 | Akhilesh Shikaripur Mohan | Dentist | 3203 Freedom Blvd Ste 400, Bryan, TX 77802-5018 | 2020-06-30 |
| 1699212951 | Magic Smiles Pllc | Dentist | 1622 W Villa Maria Rd, Suite 140, Bryan, TX 77807-2311 | 2017-01-25 |
| 1366867426 | John Albert Johnson Jr. | Dentist | 3702 Coppercrest Dr, Bryan, TX 77802-5941 | 2014-02-26 |
| 1497039846 | Theresa Coronado Foreman | Dentist | 3111 S. Texas Ave, Bryan, TX 77802 | 2011-10-04 |
| 1134407877 | Brittany Machelle Walker | Dentist | 910 N Earl Rudder Fwy, Suite 100, Bryan, TX 77802-2930 | 2011-07-29 |
| 1255667168 | J. Craig Scasta, D.d.s., Pa | Dentist | 1615 Barak Ln Ste 2, Bryan, TX 77802-3301 | 2009-10-28 |
| 1255581278 | Asha Patel | Dentist | 3111 South Texas Ave, Bryan, TX 77802-3159 | 2008-09-26 |
| 1770609349 | Tamie Erratt | Dentist | 3832 S Texas Ave, Bryan, TX 77802-3712 | 2007-03-22 |
| 1962528554 | James D Moffitt | Dentist | 1126 E Villa Maria Rd, Bryan, TX 77802-2444 | 2007-03-22 |
| 1164557377 | Drs. Hanna and Phillips D.d.s. and Associates, Inc. | Dentist | 201 Van Gundy Dr Ste A, Bryan, OH 43506-1179 | 2007-02-21 |
| Find all providers in BRYAN | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.