Active NPI
Gary W Hayes, DDS
- Oral and Maxillofacial Surgery (Dentist)
- Winona, MN
National Provider Identifier
1104836709
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Oral and Maxillofacial Surgery (Dentist)
- License
- D7987
- Practice address
- 859 Mankato Avenue
Winona, MN 55987 - Phone
- (507) 454-3680
- Fax
- (507) 457-7672
- NPI assigned
- Aug 8, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Oral and Maxillofacial Surgery (Dentist) | 1223S0112X | D7987 | MN | Primary |
Addresses
Primary practice location
859 Mankato Avenue
Winona, MN 55987
Mailing address
855 Mankato Ave
Winona Health Services
Winona, MN 55987-4868
Phone (507) 454-3680
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 582518100 | Medicaid | MN |
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| D7987 | MN | MD | Oral and Maxillofacial Surgery (Dentist) |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1154995200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1292803200000",
"number": "1104836709",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "855 MANKATO AVE",
"address_2": "WINONA HEALTH SERVICES",
"city": "WINONA",
"state": "MN",
"postal_code": "559874868",
"telephone_number": "507-454-3680",
"fax_number": "507-457-7672"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "859 MANKATO AVENUE",
"city": "WINONA",
"state": "MN",
"postal_code": "55987",
"telephone_number": "507-454-3680",
"fax_number": "507-457-7672"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HAYES",
"first_name": "GARY",
"middle_name": "W",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-08",
"last_updated": "2010-12-20",
"status": "A"
},
"taxonomies": [
{
"code": "1223S0112X",
"taxonomy_group": "",
"desc": "Dentist, Oral and Maxillofacial Surgery",
"state": "MN",
"license": "D7987",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "582518100",
"state": "MN"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Winona, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.