Provider Demographics
NPI:1750736922
Name:HAWKINS, DANIEL ROBERT (DMD)
Entity type:Individual
Prefix:
First Name:DANIEL
Middle Name:ROBERT
Last Name:HAWKINS
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:521 N 11TH ST FL 3
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23298-5016
Mailing Address - Country:US
Mailing Address - Phone:804-828-3584
Mailing Address - Fax:804-828-0056
Practice Address - Street 1:3501 TERRACE STREET SUITE 3189
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15261-5051
Practice Address - Country:US
Practice Address - Phone:412-648-9100
Practice Address - Fax:412-383-7862
Is Sole Proprietor?:No
Enumeration Date:2016-04-25
Last Update Date:2024-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA04014168651223S0112X
VA04420002821223S0112X, 204E00000X
PADS0410211223S0112X, 204E00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes204E00000XAllopathic & Osteopathic PhysiciansOral & Maxillofacial Surgery
No1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program