Provider Demographics
NPI:1023570322
Name:HASTIE, HUSTON LEWIS (DMD)
Entity type:Individual
Prefix:DR
First Name:HUSTON
Middle Name:LEWIS
Last Name:HASTIE
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 1:10 GADSTEN CT
Mailing Address - Street 2:
Mailing Address - City:PINEHURST
Mailing Address - State:NC
Mailing Address - Zip Code:28374-9646
Mailing Address - Country:US
Mailing Address - Phone:859-771-6535
Mailing Address - Fax:
Practice Address - Street 1:115 SOUTHERN DUNES DR
Practice Address - Street 2:
Practice Address - City:VASS
Practice Address - State:NC
Practice Address - Zip Code:28394-9218
Practice Address - Country:US
Practice Address - Phone:910-242-4577
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-04-04
Last Update Date:2025-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC118571223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice