Hazelton Family Dentistry, PA

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

License

D12566 Issued in MN

Legal business name

HAZELTON FAMILY DENTISTRY, PA

Practice address

677 Anne St NW
Ste F
Bemidji, MN 56601-4390

Phone

(218) 333-8668

NPI assigned

Jun 12, 2008

Organization subpart

No

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

Authorized official

Name

Zachary David Hazelton, D.D.S.NPI 1184884231

Title

Dentist

Phone

(218) 333-8668

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Zachary David Hazelton, D.D.S.

  • Dentist
  • Bemidji, MN
  • NPI 1184884231
  NPD (past) Authorized official

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

{
    "created_epoch": "1213228800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213228800000",
    "number": "1083874143",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 397",
            "city": "BEMIDJI",
            "state": "MN",
            "postal_code": "566190397",
            "telephone_number": "218-333-8668"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "677 ANNE ST NW",
            "address_2": "STE F",
            "city": "BEMIDJI",
            "state": "MN",
            "postal_code": "566014390",
            "telephone_number": "218-333-8668"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HAZELTON FAMILY DENTISTRY, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-06-12",
        "last_updated": "2008-06-12",
        "status": "A",
        "authorized_official_last_name": "HAZELTON",
        "authorized_official_first_name": "ZACHARY",
        "authorized_official_middle_name": "DAVID",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "218-333-8668",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "MN",
            "license": "D12566",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nichole J Hassebroek, CNP
• James F Hatch, MD
• Mark L Haugen, PH.D., L.P.
• Felicia Marie Hauk
• Mitchell Grant Hayle
• Jennifer Hazelton, PHARMD
• Lauren Michelle Dobson Hazelton, OD
• Zachary David Hazelton, D.D.S.
• Michael Wayne Headlee, D.C.
• Headwaters Chiropractic Center LLC

• Dental Clinic/Center in Bemidji, MN
• Providers in Bemidji, MN by specialty
• Dental Clinic/Center in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2008; 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.