Eric Haynam, D.D.S

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DN25097 Issued in FL

Practice address

401 Cecil G Costin Sr Blvd
Port St Joe, FL 32456-1928

Phone

(850) 229-1043

NPI assigned

Sep 10, 2015

Last updated

May 1, 2023By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1441843200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1682899200000",
    "number": "1043688831",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2475 GARRISON AVE",
            "city": "PORT ST JOE",
            "state": "FL",
            "postal_code": "324565265",
            "telephone_number": "850-229-1043"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 CECIL G COSTIN SR BLVD",
            "city": "PORT ST JOE",
            "state": "FL",
            "postal_code": "324561928",
            "telephone_number": "850-229-1043"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAYNAM",
        "first_name": "ERIC",
        "name_prefix": "Dr.",
        "credential": "D.D.S",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-09-10",
        "last_updated": "2023-05-01",
        "certification_date": "2023-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "63516",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN25097",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kaitlyn Hale, SLP
• Patricia A Hammonds, ARNP
• Barry L. Hand
• Stacy L Harbin, MD
• Noel Jason Hartough, LMHC
• Amy Wynn Heath, RN
• Kelley Nicole Hensley, DC
• HQM of Port St. Joe, LLC (Bay St. Joseph Care & Rehabilitation Center)
• Paul J Hunt Jr., M.D.
• Tracey Hyche, PHARMD, CPH

• General Practice Dentistry in Port St Joe, FL
• Providers in Port St Joe, FL by specialty
• General Practice Dentistry in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2023; 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.