Individual provider Active NPI

Byanka Maleyna Haine, DDS

  • Dentist
  • Dallas, TX
National Provider Identifier
1972169894
Registry record updated Apr 5, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
36317 Issued in TX
Practice address
3310 Live Oak St Ste 200
Dallas, TX 75204-6148
Phone
(214) 827-1305
NPI assigned
May 15, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 5, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Dentist 122300000X 36317 TX Primary

Addresses

Primary practice location

3310 Live Oak St Ste 200
Dallas, TX 75204-6148

Mailing address

3605 Bryan St
Dallas, TX 75204-6112
Phone (817) 658-0900

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190723003405 CT Order and Referring Only - Other (Non-Physician) 3274869607

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
36317TXMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Amerismiles Inc Dentist PastSince Apr 10, 2022 Accepting new patients

Interoperability endpoints

  • Direct secure messaging: bgonzalez425902@direct.ynhh.org

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": "1557878400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649116800000",
    "number": "1972169894",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3605 BRYAN ST",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752046112",
            "telephone_number": "817-658-0900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3310 LIVE OAK ST STE 200",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752046148",
            "telephone_number": "214-827-1305"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAINE",
        "first_name": "BYANKA",
        "middle_name": "MALEYNA",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-05-15",
        "last_updated": "2022-04-05",
        "certification_date": "2022-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TX",
            "license": "36317",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

Verify at the official NPI Registry.