Haynes Dental PLLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

28508 Issued in TX

Legal business name

HAYNES DENTAL PLLC

Practice address

1530 Texas Ave S
300
College Station, TX 77840-3329

Phone

(979) 599-5554

NPI assigned

Aug 19, 2013

Organization subpart

No

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

Authorized official

Name

Kimberly Haynes, DDS

Title

Owner

Phone

(979) 599-5554

Specialties & licenses 1

Addresses

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Sameer Bilal, DDS

  • General Practice Dentistry
  • College Station, TX
  • NPI 1174208946
  NPD (past)
• Emmanuel Sackey

  • General Practice Dentistry
  • College Station, TX
  • NPI 1003650383
  NPD (past)

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

{
    "created_epoch": "1376870400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1376870400000",
    "number": "1528491081",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3189",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132203189",
            "telephone_number": "315-454-6000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1530 TEXAS AVE S",
            "address_2": "300",
            "city": "COLLEGE STATION",
            "state": "TX",
            "postal_code": "778403329",
            "telephone_number": "979-599-5554"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HAYNES DENTAL PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-08-19",
        "last_updated": "2013-08-19",
        "status": "A",
        "authorized_official_last_name": "HAYNES",
        "authorized_official_first_name": "KIMBERLY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "979-599-5554",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "28508",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jeffrey Tate Hartley, DPT, CSCS
• Robert Wesley Hathorn, M.D.
• Roberta Lynn Hawkins, M.A., BCBA, TXLBA
• Ryan Hawkins
• Ruth Marie Haydon
• Healthline Medical Equipment LLC (Healthline)
• Rachael Hearn
• Heart of Texas Therapy Services PLLC
• Winston Allan Heath III, DDS
• Robert Warren Heffer Jr., PH.D.

• General Practice Dentistry in College Station, TX
• Providers in College Station, TX by specialty
• General Practice Dentistry in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2013; 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.