=====================================================
General NPI Number Information
=====================================================
NPI Number | 1952925166
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | HAYDEN BELL DMD
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/03/2020
-----------------------------------------------------
Last Update Date | 06/02/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 5435 ORTEGA BLVD # 1
-----------------------------------------------------
City | JACKSONVILLE
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 32210-8435
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 904-384-5571
-----------------------------------------------------
Fax | 904-384-0877
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 5435 ORTEGA BLVD # 1
-----------------------------------------------------
City | JACKSONVILLE
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 32210-8435
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 904-384-5571
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 1223G0001X
-----------------------------------------------------
Taxonomy Name | General Practice Dentistry
-----------------------------------------------------
License Number | DN24888
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------