Provider Demographics
NPI:1710448584
Name:HAYNES, LENESHIA DENEA (DDS)
Entity Type:Individual
Prefix:DR
First Name:LENESHIA
Middle Name:DENEA
Last Name:HAYNES
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2932 SAINT ANN ST
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70119-4128
Mailing Address - Country:US
Mailing Address - Phone:312-316-6056
Mailing Address - Fax:
Practice Address - Street 1:800 C M FAGAN DR STE A
Practice Address - Street 2:
Practice Address - City:HAMMOND
Practice Address - State:LA
Practice Address - Zip Code:70403-6062
Practice Address - Country:US
Practice Address - Phone:312-316-6056
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-03-26
Last Update Date:2020-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA66961223G0001X
LA6996122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty
Yes1223G0001XDental ProvidersDentistGeneral Practice