Robert D. Hazen D.D.S., PC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

130257-9921 Issued in UT

Legal business name

ROBERT D. HAZEN D.D.S., PC

Doing business as

Robert D. Hazen D.D.S., P.C

Practice address

460 S 400 E
Bountiful, UT 84010-4975

Phone

(801) 295-5586

NPI assigned

Apr 5, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Robert Dean Hazen, DDS

Title

Dentist

Phone

(801) 295-5586

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Robert D. Hazen D.D.S., P.C Doing business as

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Christian Kimball Bahr, D.D.S.

  • General Practice Dentistry
  • Bountiful, UT
  • NPI 1730328865
  NPD (past)
• J Brent Minnoch, D.D.S.

  • General Practice Dentistry
  • Bountiful, UT
  • NPI 1659543387
  NPD (past)

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

{
    "created_epoch": "1175731200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1518089960",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "460 S 400 E",
            "city": "BOUNTIFUL",
            "state": "UT",
            "postal_code": "840104975",
            "telephone_number": "801-295-5586",
            "fax_number": "801-292-5342"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "460 S 400 E",
            "city": "BOUNTIFUL",
            "state": "UT",
            "postal_code": "840104975",
            "telephone_number": "801-295-5586"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROBERT D. HAZEN D.D.S., PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-05",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "HAZEN",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "DEAN",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "801-295-5586",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "UT",
            "license": "130257-9921",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE INFORMATION",
            "identifier": "130257-9921",
            "state": "UT"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Robert D. Hazen D.D.S., P.C",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Zach Riordan
• Brenda M Ritson, MD
• Kiara Rivera
• Marissa Sophia Rivera
• Road Back LLC
• Robert W. Jordan MD PC
• Brooklyn Roberts
• Kyra Roberts
• Cara Michelle Robinson, CMHC
• Jeffrey David Robinson, PHARMD

• General Practice Dentistry in Bountiful, UT
• Providers in Bountiful, UT by specialty
• General Practice Dentistry in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.