Javauny Kristoff Hyde

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

0401419053 Issued in VA

Practice address

4500 Washington Ave
Newport News, VA 23607-2530

Phone

(757) 707-7223

NPI assigned

Apr 19, 2023

Last updated

Jul 16, 2024By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in LA

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

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

{
    "created_epoch": "1681862400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721088000000",
    "number": "1770270878",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4108 VOTIVE",
            "city": "WILLIAMSBURG",
            "state": "VA",
            "postal_code": "231883032",
            "telephone_number": "850-490-3742"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4500 WASHINGTON AVE",
            "city": "NEWPORT NEWS",
            "state": "VA",
            "postal_code": "236072530",
            "telephone_number": "757-707-7223"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3342 Toledo Ter Apt 405",
            "address_purpose": "LOCATION",
            "city": "West Hyattsville",
            "state": "MD",
            "postal_code": "207821375",
            "country_code": "US",
            "telephone_number": "850-490-3742",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1499 Central Park Blvd Unit 1221",
            "address_purpose": "LOCATION",
            "city": "Harvey",
            "state": "LA",
            "postal_code": "700581375",
            "country_code": "US",
            "telephone_number": "850-490-3742",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HYDE",
        "first_name": "JAVAUNY",
        "middle_name": "KRISTOFF",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-04-19",
        "last_updated": "2024-07-16",
        "certification_date": "2024-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "LA",
            "license": "7511",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "VA",
            "license": "0401419053",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• General Practice Dentistry in Newport News, VA
• Providers in Newport News, VA by specialty
• General Practice Dentistry in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2024; 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.