Provider Demographics
NPI:1598077851
Name:HAYASHI, MARC (DMD)
Entity Type:Individual
Prefix:DR
First Name:MARC
Middle Name:
Last Name:HAYASHI
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7765 W 91ST ST UNIT A3122
Mailing Address - Street 2:
Mailing Address - City:PLAYA DEL REY
Mailing Address - State:CA
Mailing Address - Zip Code:90293-7316
Mailing Address - Country:US
Mailing Address - Phone:206-795-5327
Mailing Address - Fax:
Practice Address - Street 1:100 MEDICAL PLAZA DRIVEWAY SUITE #350
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90095-2820
Practice Address - Country:US
Practice Address - Phone:310-794-5750
Practice Address - Fax:310-825-2951
Is Sole Proprietor?:No
Enumeration Date:2010-07-02
Last Update Date:2021-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE 601283171223G0001X
CA600541223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice