Tyson Hazard

Primary specialty

DentistTaxonomy code 122300000X

License

13009954-9926 Issued in UT

Practice address

7321 Balmer Ave.
Hill AFB, UT 84041

Phone

(801) 777-7011

NPI assigned

Apr 12, 2022

Last updated

Dec 3, 2024By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1649721600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733184000000",
    "number": "1316689995",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7321 BALMER AVE.",
            "city": "HILL AFB",
            "state": "UT",
            "postal_code": "84041",
            "telephone_number": "801-777-7011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7321 BALMER AVE.",
            "city": "HILL AFB",
            "state": "UT",
            "postal_code": "84041",
            "telephone_number": "801-777-7011"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "155 5th St",
            "address_purpose": "LOCATION",
            "city": "San Francisco",
            "state": "CA",
            "postal_code": "941032919",
            "country_code": "US",
            "telephone_number": "385-231-8522",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HAZARD",
        "first_name": "TYSON",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-04-12",
        "last_updated": "2024-12-03",
        "certification_date": "2024-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "UT",
            "license": "13009954-9926",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jeffrey C Guerttman, IDMT
• Ann-Therese Guillory, RN
• Tamera Jo Hall, IDMT
• Kammi Marie Hansen, R.D.
• Jeffrey Nathan Harris, M.D.
• Kristina Hernandez, LCSW
• Stacey Marchus Hickman, PT
• Hani Hijazi, D.D.S.
• Mark Edward Hoggan, MD
• Tyler Hollmann

• Dentist in Hill AFB, UT
• Providers in Hill AFB, UT by specialty
• Dentist in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2024; 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.