Axiom Dental Laboratories LLC

Primary specialty

Dental LaboratoryTaxonomy code 292200000X

Legal business name

AXIOM DENTAL LABORATORIES LLC

Practice address

25336 NW 9TH LN
Newberry, FL 32669-3589

Phone

(352) 538-9848

NPI assigned

Jan 13, 2022

Organization subpart

No

Name

Tyler Alan Hansen

Title

Ceo/Founder

Phone

(352) 538-9848

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jan 13, 2022.

{
    "created_epoch": "1642032000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1642032000000",
    "number": "1043961865",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25336 NW 9TH LN",
            "city": "NEWBERRY",
            "state": "FL",
            "postal_code": "326693589",
            "telephone_number": "352-538-9848"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25336 NW 9TH LN",
            "city": "NEWBERRY",
            "state": "FL",
            "postal_code": "326693589",
            "telephone_number": "352-538-9848"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AXIOM DENTAL LABORATORIES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-01-13",
        "last_updated": "2022-01-13",
        "certification_date": "2022-01-12",
        "status": "A",
        "authorized_official_last_name": "HANSEN",
        "authorized_official_first_name": "TYLER",
        "authorized_official_middle_name": "ALAN",
        "authorized_official_title_or_position": "CEO/FOUNDER",
        "authorized_official_telephone_number": "352-538-9848"
    },
    "taxonomies": [
        {
            "code": "292200000X",
            "taxonomy_group": "",
            "desc": "Dental Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.