Provider Demographics
NPI:1821798810
Name:HAYUT, ANNA (DDS)
Entity Type:Individual
Prefix:DR
First Name:ANNA
Middle Name:
Last Name:HAYUT
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 1:1556 BRADFORD TRACE DR
Mailing Address - Street 2:
Mailing Address - City:ALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:75002-0962
Mailing Address - Country:US
Mailing Address - Phone:972-865-5734
Mailing Address - Fax:
Practice Address - Street 1:1110 E PARKER RD STE 110
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75074-5363
Practice Address - Country:US
Practice Address - Phone:972-265-0111
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-08
Last Update Date:2023-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX39532122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist