Provider Demographics
NPI:1629685185
Name:BAYNES, RHETT AUSTIN
Entity type:Individual
Prefix:DR
First Name:RHETT
Middle Name:AUSTIN
Last Name:BAYNES
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3268 GREYLING DR
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92123-2230
Mailing Address - Country:US
Mailing Address - Phone:760-828-8250
Mailing Address - Fax:
Practice Address - Street 1:3268 GREYLING DR
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92123-2230
Practice Address - Country:US
Practice Address - Phone:760-828-8250
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-29
Last Update Date:2025-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1076761223G0001X
IDD-52091223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice