NPIMap

Organization Active NPI

Samuel M.Hazel, DMD LLC

  • General Practice Dentistry
  • Walterboro, SC
National Provider Identifier
1689883662
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
2032 Issued in SC
Legal business name
SAMUEL M.HAZEL, DMD LLC
Practice address
415 Robertson Blvd Ste a
Walterboro, SC 29488-5713
Phone
(843) 549-2121
Fax
(843) 549-7705
NPI assigned
May 22, 2007
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Samuel Michael HazelNPI 1477616555
Title
Owner
Phone
(843) 549-2121

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 2032 SC Primary

Addresses

Primary practice location

415 Robertson Blvd Ste a
Walterboro, SC 29488-5713

Mailing address

415 Robertson Blvd Ste a
Walterboro, SC 29488-5713
Phone (843) 549-2121

Other identifiers 1

IdentifierTypeStateIssuer
ZA9870MedicaidSC

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1179792000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1689883662",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "415 ROBERTSON BLVD STE A",
            "city": "WALTERBORO",
            "state": "SC",
            "postal_code": "294885713",
            "telephone_number": "843-549-2121",
            "fax_number": "843-549-7705"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "415 ROBERTSON BLVD STE A",
            "city": "WALTERBORO",
            "state": "SC",
            "postal_code": "294885713",
            "telephone_number": "843-549-2121",
            "fax_number": "843-549-7705"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAMUEL M.HAZEL, DMD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-22",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "HAZEL",
        "authorized_official_first_name": "SAMUEL",
        "authorized_official_middle_name": "MICHAEL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "843-549-2121",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "SC",
            "license": "2032",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ZA9870",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Walterboro, SC

Sources for this page

  • 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.