Active NPI
Jessica Amanda Hardy, DMD
- Dentist
- Price, UT
National Provider Identifier
1124507363
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- D010048
- Practice address
- 1588 N. Coal Creek Rd.
Price, UT 84501-8450 - Phone
- (435) 820-6666
- NPI assigned
- Aug 8, 2018
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | D010048 | AZ | Primary |
Addresses
Primary practice location
1588 N. Coal Creek Rd.
Price, UT 84501-8450
Mailing address
1588 N Coal Creek Rd
Price, UT 84501-7615
Phone (435) 820-6666
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| D010048 | Other | AZ | ARIZONA STATE BOARD OF DENTAL EXAMINERS |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| D010048 | AZ | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1533686400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1533686400000",
"number": "1124507363",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1588 N COAL CREEK RD",
"city": "PRICE",
"state": "UT",
"postal_code": "845017615",
"telephone_number": "435-820-6666"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1588 N. COAL CREEK RD.",
"city": "PRICE",
"state": "UT",
"postal_code": "845018450",
"telephone_number": "435-820-6666"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HARDY",
"first_name": "JESSICA",
"middle_name": "AMANDA",
"credential": "DMD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2018-08-08",
"last_updated": "2018-08-08",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "AZ",
"license": "D010048",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ARIZONA STATE BOARD OF DENTAL EXAMINERS",
"identifier": "D010048",
"state": "AZ"
}
],
"endpoints": [],
"other_names": []
}Other providers in Price, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.