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DR. EVAN HATHAWAY DDS
NPI 1033455019
Dentist in Eagle, ID

Active since December 20, 2012PECOS Enrolled
1217 E IRON EAGLE DR, EAGLE, ID 83616(208) 377-1161(208) 938-0567 Get Directions Write a Review

NPPES record last updated: December 20, 2012. Verified against the NPPES registry weekly; last sync: September 06, 2026.

About Dr. Evan Hathaway Dds NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. EVAN HATHAWAY DDS (NPI 1033455019) is an individual dentist in Eagle, Idaho, licensed in Idaho (D2040) and active in the NPI registry since December 2012. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1033455019
Entity TypeIndividualMale
Primary Taxonomy122300000X
Provider Legal NameDR. EVAN HATHAWAYCredential: DDS
Location Address1217 E IRON EAGLE DREagle, ID 83616-6599
Mailing Address1217 E Iron Eagle DrEagle, ID 83616-6599 · (208) 377-1161 · Fax (208) 938-0567
Phone(208) 377-1161
Fax(208) 938-0567
Sole ProprietorYes
Enumeration DateDecember 20, 2012
✔ NPI 1033455019 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentistDental Providers
Taxonomy Code122300000X
License✔ Licensed in ID · D2040
Definition
A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist.
1217 E IRON EAGLE DR, Eagle, ID 83616
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, BEST Life, Blue Cross and Blue Shield of Montana and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Evan Hathaway Dds is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 83616 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$81.13 typical visit price
range $52.44 – $160.17
Typical copayment $20.28 (range $13.11 – $40.04)
Most-billed visit code 99203
Established Patient
$65.77 typical visit price
range $16.68 – $130.93
Typical copayment $16.44 (range $4.17 – $32.73)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 4

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

HATHAWAY AND PELLETIER FAMILY DENTAL PLLC
Clinic/Center (Dental)
1217 E IRON EAGLE DR
EAGLE, ID 83616
Ada County (208) 377-1161
EVAN HATHAWAY DDS PA
Dentist
1217 E IRON EAGLE DR
EAGLE, ID 83616
Ada County (208) 377-1161
CHRISTIAN PUTEGNAT
Dentist
1217 E IRON EAGLE DR
EAGLE, ID 83616
Ada County (208) 228-7093
CHRISTIAN PUTEGNAT DMD PLLC
Clinic/Center (Dental)
1217 E IRON EAGLE DR
EAGLE, ID 83616
Ada County (208) 377-1161

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Evan Hathaway's NPI number?

The NPI number for Evan Hathaway is 1033455019. It was assigned to this individual provider in the NPPES registry on December 20, 2012.

Where is Evan Hathaway located?

Evan Hathaway practices at 1217 E Iron Eagle Dr, Eagle, ID 83616. The listed phone number is (208) 377-1161.

What is Evan Hathaway's specialty?

The primary specialty registered for this NPI is Dentist with taxonomy code 122300000X.

Is Evan Hathaway enrolled in Medicare?

Yes. Evan Hathaway is registered in the Medicare PECOS enrollment system.

What insurance does Evan Hathaway accept?

Health plans from Anthem Blue Cross and Blue Shield, BEST Life, Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma and Blue Cross and Blue Shield of Texas and 5 other insurers list Evan Hathaway as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Evan Hathaway was last updated on December 20, 2012. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.