Provider Demographics
NPI:1457545055
Name:HAYES, SHAUNA DANIELLE (DMD)
Entity Type:Individual
Prefix:DR
First Name:SHAUNA
Middle Name:DANIELLE
Last Name:HAYES
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:116 N HALCYON RD
Mailing Address - Street 2:
Mailing Address - City:ARROYO GRANDE
Mailing Address - State:CA
Mailing Address - Zip Code:93420-2523
Mailing Address - Country:US
Mailing Address - Phone:805-481-0800
Mailing Address - Fax:805-481-0801
Practice Address - Street 1:116 N HALCYON RD
Practice Address - Street 2:
Practice Address - City:ARROYO GRANDE
Practice Address - State:CA
Practice Address - Zip Code:93420-2523
Practice Address - Country:US
Practice Address - Phone:805-481-0800
Practice Address - Fax:805-481-0801
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-28
Last Update Date:2010-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA592841223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice