Individual provider Active NPI

Carrie Elizabeth Hazey, D.D.S

  • General Practice Dentistry
  • Clarksburg, WV
National Provider Identifier
1063589737
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
3572 Issued in WV
Practice address
720 E Pike St
Clarksburg, WV 26301-2240
Phone
(304) 622-0595
NPI assigned
Nov 29, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 3572 WV Primary

Addresses

Primary practice location

720 E Pike St
Clarksburg, WV 26301-2240

Mailing address

1395 Briarwood Rd
Bridgeport, WV 26330-9449
Phone (304) 842-2465

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160414001557 WV Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 2668770249

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3572WVMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Carrie E. Hazey, DDS, Inc. CurrentSince Jun 15, 2021 Accepting new patients
Michael a. Hazey II, D.D.S., Inc. Past Accepting new patients

Locations

720 E Pike St
Clarksburg, WV 26301
Phone (304) 622-0595

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1164758400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1063589737",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1395 BRIARWOOD RD",
            "city": "BRIDGEPORT",
            "state": "WV",
            "postal_code": "263309449",
            "telephone_number": "304-842-2465"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "720 E PIKE ST",
            "city": "CLARKSBURG",
            "state": "WV",
            "postal_code": "263012240",
            "telephone_number": "304-622-0595"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAZEY",
        "first_name": "CARRIE",
        "middle_name": "ELIZABETH",
        "name_prefix": "Dr.",
        "credential": "D.D.S",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-29",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WV",
            "license": "3572",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clarksburg, WV

Sources for this page

Verify at the official NPI Registry.