Individual provider Active NPI

Emily Hazelbush, RDH

  • Dental Hygienist
  • Blanchard, OK
National Provider Identifier
1760768097
Registry record updated Jan 13, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental HygienistTaxonomy code 124Q00000X
License
4362 Issued in OK
Practice address
5551 Mockingbird LN
Blanchard, OK 73010-7862
Phone
(214) 681-0568
NPI assigned
Nov 1, 2011
Last updated
Jan 13, 2020By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 13, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Hygienist 124Q00000X 4362 OK Primary
Dental Hygienist 124Q00000X 905522 CO

Addresses

Primary practice location

5551 Mockingbird LN
Blanchard, OK 73010-7862

Mailing address

5551 Mockingbird LN
Blanchard, OK 73010-7862
Phone (214) 681-0568

Other practice location 1

225 Callahan Ave
Parachute, CO 81635-8708
Phone (970) 285-7748

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

LicenseStateTypeSpecialty
905522COMDDental Hygienist

Practice roles

OrganizationSpecialtyStatusNew patients
H Dentistry, PLLC PastSince Nov 24, 2019 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1320105600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1578873600000",
    "number": "1760768097",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5551 MOCKINGBIRD LN",
            "city": "BLANCHARD",
            "state": "OK",
            "postal_code": "730107862",
            "telephone_number": "214-681-0568"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5551 MOCKINGBIRD LN",
            "city": "BLANCHARD",
            "state": "OK",
            "postal_code": "730107862",
            "telephone_number": "214-681-0568"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "225 Callahan Ave",
            "address_purpose": "LOCATION",
            "city": "Parachute",
            "state": "CO",
            "postal_code": "816358708",
            "country_code": "US",
            "telephone_number": "970-285-7748",
            "fax_number": "970-285-6824",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HAZELBUSH",
        "first_name": "EMILY",
        "credential": "RDH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-11-01",
        "last_updated": "2020-01-13",
        "certification_date": "2020-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "124Q00000X",
            "taxonomy_group": "",
            "desc": "Dental Hygienist",
            "state": "OK",
            "license": "4362",
            "primary": true
        },
        {
            "code": "124Q00000X",
            "taxonomy_group": "",
            "desc": "Dental Hygienist",
            "state": "CO",
            "license": "905522",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Blanchard, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 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.