Individual provider Active NPI

Kristy Lynn Hayes, DMD

  • Pediatric Dentistry
  • San Diego, CA
National Provider Identifier
1134311004
Registry record updated Apr 19, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
64251 Issued in CA
Practice address
239 Laurel St
Suite 201
San Diego, CA 92101-1472
Phone
(619) 291-5266
Fax
(619) 291-0124
NPI assigned
Aug 15, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 19, 2016

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 30.022632 OH
Pediatric Dentistry 1223P0221X 30.022632 OH
Pediatric Dentistry 1223P0221X 64251 CA Primary

Addresses

Primary practice location

239 Laurel St
Suite 201
San Diego, CA 92101-1472

Mailing address

239 Laurel St
Suite 201
San Diego, CA 92101-1472
Phone (619) 291-5266

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
30.022632OHMDPediatric Dentist
64251CAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Durschlag Dental Corp PastSince Aug 16, 2020 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1187136000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1461024000000",
    "number": "1134311004",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "239 LAUREL ST",
            "address_2": "SUITE 201",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921011472",
            "telephone_number": "619-291-5266",
            "fax_number": "619-291-0124"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "239 LAUREL ST",
            "address_2": "SUITE 201",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921011472",
            "telephone_number": "619-291-5266",
            "fax_number": "619-291-0124"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAYES",
        "first_name": "KRISTY",
        "middle_name": "LYNN",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-08-15",
        "last_updated": "2016-04-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OH",
            "license": "30.022632",
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "OH",
            "license": "30.022632",
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "CA",
            "license": "64251",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2016; 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.