Provider Demographics
NPI:1003542903
Name:DEPREZ, HAYDEN ELIZABETH (DDS)
Entity Type:Individual
Prefix:
First Name:HAYDEN
Middle Name:ELIZABETH
Last Name:DEPREZ
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:634 B ST
Mailing Address - Street 2:
Mailing Address - City:FORT RICHARDSON
Mailing Address - State:AK
Mailing Address - Zip Code:99505-6650
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:634 B ST
Practice Address - Street 2:
Practice Address - City:FORT RICHARDSON
Practice Address - State:AK
Practice Address - Zip Code:99505-6650
Practice Address - Country:US
Practice Address - Phone:907-384-2483
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-25
Last Update Date:2023-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN12013772A122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist