NPIMap

Organization Active NPI

Michael a. Hazey II, D.D.S., Inc.

  • Dental Clinic/Center
  • Clarksburg, WV
National Provider Identifier
1174826275
Registry record updated Mar 11, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
License
2255 Issued in WV
Legal business name
MICHAEL A. HAZEY II, D.D.S., INC.
Practice address
720 E Pike St
Clarksburg, WV 26301-2240
Phone
(304) 622-0595
Fax
(304) 622-6290
NPI assigned
Dec 10, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 11, 2013

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

Authorized official

Name
Dr. Michael A. Hazey II, DDSNPI 1891895330
Title
Dentist
Phone
(304) 622-0595

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X 2255 WV Primary

Addresses

Primary practice location

720 E Pike St
Clarksburg, WV 26301-2240

Mailing address

720 E Pike St
Clarksburg, WV 26301-2240
Phone (304) 622-0595

Other identifiers 1

IdentifierTypeStateIssuer
CKWV1MedicaidWV

Other names 1

  • Hazey Dental Associates Other name

National Provider Directory

National Provider Directory

Locations

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

Practitioners & affiliated clinicians

Practitioners 2

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

NPI Registry JSON

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

{
    "created_epoch": "1291939200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1362960000000",
    "number": "1174826275",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "720 E PIKE ST",
            "city": "CLARKSBURG",
            "state": "WV",
            "postal_code": "263012240",
            "telephone_number": "304-622-0595",
            "fax_number": "304-622-6290"
        },
        {
            "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",
            "fax_number": "304-622-6290"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MICHAEL A. HAZEY II, D.D.S., INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-12-10",
        "last_updated": "2013-03-11",
        "status": "A",
        "authorized_official_last_name": "HAZEY",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "A.",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "304-622-0595",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "II",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "WV",
            "license": "2255",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "CKWV1",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Hazey Dental Associates",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Clarksburg, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2013; 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.