Individual provider Active NPI

Shaylar Marcal Hatch, DMD

  • Dentist
  • Mesa, AZ
National Provider Identifier
1215331673
Registry record updated Oct 14, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
D06963 Issued in AZ
Practice address
4135 S Power Rd Ste 101
Mesa, AZ 85212-3625
Phone
(480) 525-6000
Fax
(480) 525-6001
NPI assigned
Oct 14, 2014
Last updated
Oct 14, 2014By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 14, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X D06963 AZ Primary

Addresses

Primary practice location

4135 S Power Rd Ste 101
Mesa, AZ 85212-3625

Mailing address

4374 E Santa Fe CT
Gilbert, AZ 85297-7942
Phone (480) 353-7285

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

LicenseStateTypeSpecialty
D06963AZMDDentist

Organizations & group practices 1

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": "1413244800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1413244800000",
    "number": "1215331673",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4374 E SANTA FE CT",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852977942",
            "telephone_number": "480-353-7285",
            "fax_number": "480-525-6001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4135 S POWER RD STE 101",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852123625",
            "telephone_number": "480-525-6000",
            "fax_number": "480-525-6001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HATCH",
        "first_name": "SHAYLAR",
        "middle_name": "MARCAL",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-10-14",
        "last_updated": "2014-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "AZ",
            "license": "D06963",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mesa, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2014; 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.