Individual provider Active NPI

Tyler Sarazin, DDS

  • Dentist
  • Hancock, MI
National Provider Identifier
1356754170
Registry record updated Jun 9, 2014
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Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
2901021243 Issued in MI
Practice address
528 Quincy St
Hancock, MI 49930-1846
Phone
(906) 482-8601
Fax
(906) 482-9953
NPI assigned
Jun 9, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 9, 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 2901021243 MI Primary

Addresses

Primary practice location

528 Quincy St
Hancock, MI 49930-1846

Mailing address

528 Quincy St
Hancock, MI 49930-1846
Phone (906) 482-8601

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20161201000154 MI Order and Referring Only - DentistPractitioner - Dentist 6507146065

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Sarazin Dental PC Dentist Past Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1402272000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1402272000000",
    "number": "1356754170",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "528 QUINCY ST",
            "city": "HANCOCK",
            "state": "MI",
            "postal_code": "499301846",
            "telephone_number": "906-482-8601",
            "fax_number": "906-482-9953"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "528 QUINCY ST",
            "city": "HANCOCK",
            "state": "MI",
            "postal_code": "499301846",
            "telephone_number": "906-482-8601",
            "fax_number": "906-482-9953"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SARAZIN",
        "first_name": "TYLER",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-06-09",
        "last_updated": "2014-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MI",
            "license": "2901021243",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hancock, MI

Sources for this page

Verify at the official NPI Registry.