Active NPI
Randy Steven Hurley, D.D.S.
- General Practice Dentistry
- Prescott, AZ
National Provider Identifier
1144359092
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 4339
- Practice address
- 1151 W Iron Springs Rd
Suite F
Prescott, AZ 86305-1614 - Phone
- (928) 771-2526
- Fax
- (928) 777-2469
- NPI assigned
- Mar 5, 2007
- Sex
- Male
- 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 |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 4339 | AZ | Primary |
Addresses
Primary practice location
1151 W Iron Springs Rd
Suite F
Prescott, AZ 86305-1614
Mailing address
1151 W Iron Springs Rd
Suite F
Prescott, AZ 86305-1614
Phone (928) 771-2526
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 4339 | Other | AZ | STATE DENTAL LICENSE |
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 |
|---|---|---|---|
| 4339 | AZ | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1173052800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1144359092",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1151 W IRON SPRINGS RD",
"address_2": "SUITE F",
"city": "PRESCOTT",
"state": "AZ",
"postal_code": "863051614",
"telephone_number": "928-771-2526",
"fax_number": "928-777-2469"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1151 W IRON SPRINGS RD",
"address_2": "SUITE F",
"city": "PRESCOTT",
"state": "AZ",
"postal_code": "863051614",
"telephone_number": "928-771-2526",
"fax_number": "928-777-2469"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HURLEY",
"first_name": "RANDY",
"middle_name": "STEVEN",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-03-05",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "AZ",
"license": "4339",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE DENTAL LICENSE",
"identifier": "4339",
"state": "AZ"
}
],
"endpoints": [],
"other_names": []
}Other providers in Prescott, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.