JENNIFER A HATHAWAY DDS PA
NPI 1972139764
Durable Medical Equipment & Medical Supplies - Customized Equipment in Bryan, TX
About Jennifer A Hathaway Dds Pa NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
JENNIFER A HATHAWAY DDS PA (NPI 1972139764) is a healthcare organization registered as a customized equipment in Bryan, Texas and active in the NPI registry since March 2020. The organization lists Stevie Fester, Practice Manager, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Medicare Participation & PECOS CMS
Medicare enrollment and revalidation status from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Jennifer A Hathaway Dds Pa is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Revalidation Due Date
Revalidation due by March 31, 2027
Medicare-enrolled providers and suppliers confirm their enrollment information with CMS on a set cycle, every 5 years for most and every 3 years for medical equipment suppliers. CMS sets the due date for each enrollment.
Other Providers at the Same Location NPPES
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
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 Jennifer A Hathaway Dds PA's NPI number?
The NPI number for Jennifer A Hathaway Dds PA is 1972139764. It was assigned to this organization in the NPPES registry on March 12, 2020.
Where is Jennifer A Hathaway Dds PA located?
Jennifer A Hathaway Dds PA is located at 1719 Broadmoor Dr, Bryan, TX 77802. The listed phone number is (979) 776-6884.
What is Jennifer A Hathaway Dds PA's specialty?
The primary specialty registered for this NPI is Durable Medical Equipment & Medical Supplies, specializing in Customized Equipment, with taxonomy code 332BC3200X.
Is Jennifer A Hathaway Dds PA enrolled in Medicare?
Yes. Jennifer A Hathaway Dds PA is registered in the Medicare PECOS enrollment system.
When is Jennifer A Hathaway Dds PA's Medicare revalidation due?
According to the CMS Revalidation Due Date List (October 2026 release), the Medicare DME enrollment for this organization (Texas, Oral Surgery - Dentist) is due for revalidation by March 31, 2027. Medicare providers and suppliers revalidate their enrollment every 5 years, and medical equipment suppliers every 3 years. Confirm current requirements with your Medicare Administrative Contractor.
When was this NPI record last updated?
The NPPES record for Jennifer A Hathaway Dds PA was last updated on March 21, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.
# Jennifer A Hathaway Dds Pa · NPI 1972139764
Customized Equipment organization in Bryan, Texas. Organization record, active in the CMS NPPES registry since March 12, 2020.
## Identity
- **NPI:** 1972139764 (Entity type: Organization)
- **Enumerated:** March 12, 2020
- **Primary specialty:** Durable Medical Equipment & Medical Supplies - Customized Equipment · taxonomy 332BC3200X
- **Organization subpart:** No
- **Authorized official:** Stevie Fester, PRACTICE MANAGER
## Practice location
- **Address:** 1719 BROADMOOR DR, Bryan, TX 77802-5210
- **Phone:** (979) 776-6884 · **Fax:** (979) 774-3008
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Medicare revalidation due:** March 31, 2027 (DME, Texas, Oral Surgery - Dentist) · CMS Revalidation Due Date List, October 2026 release
## Record status
- **NPPES last updated:** March 21, 2023
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Source: [NPI Profile](https://npiprofile.com/npi/1972139764) · Data from the CMS NPPES public registry.