Andrea Goatley Haydon, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

6676 Issued in KY

Practice address

202 W Stephen Foster Ave
Suite E
Bardstown, KY 40004-1472

Phone

(503) 348-0908

Fax

(502) 348-0948

NPI assigned

Jan 8, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in KY

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Andrea G. Haydon, DMD PLLC

  • Dentist
  • Bardstown, KY
  • NPI 1487803367
  NPD (past) Authorized official

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

{
    "created_epoch": "1168214400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1710035472",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "202 W STEPHEN FOSTER AVE",
            "address_2": "SUITE E",
            "city": "BARDSTOWN",
            "state": "KY",
            "postal_code": "400041472",
            "telephone_number": "503-348-0908",
            "fax_number": "502-348-0948"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "202 W STEPHEN FOSTER AVE",
            "address_2": "SUITE E",
            "city": "BARDSTOWN",
            "state": "KY",
            "postal_code": "400041472",
            "telephone_number": "503-348-0908",
            "fax_number": "502-348-0948"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAYDON",
        "first_name": "ANDREA",
        "middle_name": "GOATLEY",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-08",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "KY",
            "license": "6676",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6000075900",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Michael E Harris, DDS MSD
• Theresa Catherine Harris, ARNP
• Jennifer A Hayden, PT, ATC
• Kristin L Hayden, MHA
• Mariam Haydon Dones, PT, DPT
• Meghan Elise Hayes, PA-C
• Hazard Hills, LLC
• Elizabeth Lena Jean Heaton, APRN
• Heaven'S Halo
• Lauren Michelle Hedgespeth, D.M.D.

• General Practice Dentistry in Bardstown, KY
• Providers in Bardstown, KY by specialty
• General Practice Dentistry in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.