Active NPI
Hunter Lamkin Hazle
- Pediatric Dentistry
- Novi, MI
National Provider Identifier
1255851291
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Dentistry
- License
- 2901601455
- Practice address
- 43025 W 12 Mile Rd
Novi, MI 48377-3012 - Phone
- (502) 774-4401
- NPI assigned
- Jun 21, 2017
- Last updated
- Mar 19, 2025
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2901601455 | Other | MI | MI SPECIALTY LICENSE - PEDIATRIC DENTISTRY |
| 2901601455 | Other | MI | MI DENTAL LICENSE |
| 9940 | Other | KY | KY 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 |
|---|---|---|---|
| 9940 | KY | MD | General Practice Dentistry |
| 2901601455 | MI | MD | Pediatric Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Rastogi and Maxwell PLLC | Pediatric Dentistry | Current | Accepting new patients |
| Hazle Maxwell Rastogi PLLC | Pediatric Dentistry | Past | Accepting new patients |
Locations
43025 W Twelve Mile Rd
Novi, MI 48377
Phone (248) 478-3232
Interoperability endpoints
- 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.
-
- Pediatric Dentistry
- Novi, MI
- NPI 1588908917
-
dba Olde Orchard Pediatric Dentistry Brighton
- Pediatric Dentistry
- Brighton, MI
- NPI 1194656355
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.