Active NPI
Susan M Haynes
- Dentist
- Kingman, AZ
National Provider Identifier
1922264563
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 7531
- Practice address
- 2065 Airway Ave
Suite B
Kingman, AZ 86409-3656 - Phone
- (928) 692-1100
- NPI assigned
- Aug 4, 2008
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Dentist | 122300000X | 7531 | AZ | Primary |
Addresses
Primary practice location
2065 Airway Ave
Suite B
Kingman, AZ 86409-3656
Mailing address
3215 Isador Ave
Kingman, AZ 86401-6471
Phone (928) 279-9623
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
| License | State | Type | Specialty |
|---|---|---|---|
| 7531 | AZ | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1217808000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1290988800000",
"number": "1922264563",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3215 ISADOR AVE",
"city": "KINGMAN",
"state": "AZ",
"postal_code": "864016471",
"telephone_number": "928-279-9623"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2065 AIRWAY AVE",
"address_2": "SUITE B",
"city": "KINGMAN",
"state": "AZ",
"postal_code": "864093656",
"telephone_number": "928-692-1100"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HAYNES",
"first_name": "SUSAN",
"middle_name": "M",
"name_prefix": "Dr.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-08-04",
"last_updated": "2010-11-29",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "AZ",
"license": "7531",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Kingman, AZ
- Treeva Hausen
- Havasu Dental Group 1 PLLC
- John Brit Haws, PT, DPT
- Patricia D Haydon, D.C.
- Joseph Haydu, M.D.
- Healthcare Management Professional, Inc. (The Gardens Rehab & Care Center)
- Heart Institute of Northern Arizona LLC
- Heart Institute of Northern Arizona LLC
- Margot D Henderson, P.A.-C.
- Shirley Kathryn Henderson, LICENSED COUNSELOR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 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.