Individual provider Active NPI

Hunter Lamkin Hazle

  • Pediatric Dentistry
  • Novi, MI
National Provider Identifier
1255851291
Registry record updated Mar 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
2901601455 Issued in MI
Practice address
43025 W 12 Mile Rd
Novi, MI 48377-3012
Phone
(502) 774-4401
NPI assigned
Jun 21, 2017
Last updated
Mar 19, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 19, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 9940 KY
Pediatric Dentistry 1223P0221X 2901601455 MI Primary

Addresses

Primary practice location

43025 W 12 Mile Rd
Novi, MI 48377-3012

Mailing address

43025 W 12 Mile Rd
Novi, MI 48377-3012
Phone (502) 774-4401

Other identifiers 3

IdentifierTypeStateIssuer
2901601455OtherMIMI SPECIALTY LICENSE - PEDIATRIC DENTISTRY
2901601455OtherMIMI DENTAL LICENSE
9940OtherKYKY 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

LicenseStateTypeSpecialty
9940KYMDGeneral Practice Dentistry
2901601455MIMDPediatric Dentist

Practice roles

OrganizationSpecialtyStatusNew patients
Rastogi and Maxwell PLLC Pediatric Dentistry CurrentSince Jan 7, 2024 Accepting new patients
Hazle Maxwell Rastogi PLLC Pediatric Dentistry PastSince Jun 21, 2022 Accepting new patients

Locations

43025 W Twelve Mile Rd
Novi, MI 48377
Phone (248) 478-3232

Interoperability endpoints

  • Direct secure messaging: hhazle32746@ukhcdirect.org

Organizations & group practices 2

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": "1498003200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742342400000",
    "number": "1255851291",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "43025 W 12 MILE RD",
            "city": "NOVI",
            "state": "MI",
            "postal_code": "483773012",
            "telephone_number": "502-774-4401"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "43025 W 12 MILE RD",
            "city": "NOVI",
            "state": "MI",
            "postal_code": "483773012",
            "telephone_number": "502-774-4401"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAZLE",
        "first_name": "HUNTER",
        "middle_name": "LAMKIN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-06-21",
        "last_updated": "2025-03-19",
        "certification_date": "2025-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "KY",
            "license": "9940",
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "MI",
            "license": "2901601455",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MI SPECIALTY LICENSE - PEDIATRIC DENTISTRY",
            "identifier": "2901601455",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MI DENTAL LICENSE",
            "identifier": "2901601455",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KY DENTAL LICENSE",
            "identifier": "9940",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Novi, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2025; 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.