Provider Demographics
NPI:1316767080
Name:HAWKS, ANDREW (DMD, MS)
Entity type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:
Last Name:HAWKS
Suffix:
Gender:M
Credentials:DMD, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11442 S WATERCOURSE RD
Mailing Address - Street 2:
Mailing Address - City:SOUTH JORDAN
Mailing Address - State:UT
Mailing Address - Zip Code:84009-1827
Mailing Address - Country:US
Mailing Address - Phone:801-652-4825
Mailing Address - Fax:
Practice Address - Street 1:10654 S RIVER HEIGHTS DR STE 310
Practice Address - Street 2:
Practice Address - City:SOUTH JORDAN
Practice Address - State:UT
Practice Address - Zip Code:84095-5544
Practice Address - Country:US
Practice Address - Phone:801-254-6900
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-16
Last Update Date:2024-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT13889174-99261223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty