Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Dr. Evan Hathaway, DDS

Individual provider Dentist · NPI 1033455019

Dr. Evan Hathaway, DDS is a Dentist in Eagle, Idaho. Practices as a sole proprietor. Licensed in Idaho.

Licensed in
ID
In the registry since
2012
What do these letters mean?
DDS — Doctor of Dental Surgery
A dentist. DDS and DMD are the same qualification — universities choose which title to award.

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Practice location Address checks out

1217 E Iron Eagle Dr
Eagle, ID 83616-6599
Phone: (208) 377-1161
Fax: (208) 938-0567
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Dentist (primary) Taxonomy 122300000X · Licence D2040 (ID)

Record details

NPI number1033455019
Entity typeIndividual (Type 1)
GenderMale
Credentials DDS
Sole proprietorYes
NPI enumeratedDecember 20, 2012
Last updated in NPPESDecember 20, 2012
Mailing address1217 E Iron Eagle Dr, Eagle, ID 83616-6599

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