Provider Demographics
NPI:1700378007
Name:HAYES, AMANDA (DMD)
Entity Type:Individual
Prefix:DR
First Name:AMANDA
Middle Name:
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 1:51 OVERLOOK RIDGE DR APT 7510
Mailing Address - Street 2:
Mailing Address - City:MALDEN
Mailing Address - State:MA
Mailing Address - Zip Code:02148-5051
Mailing Address - Country:US
Mailing Address - Phone:321-698-4519
Mailing Address - Fax:
Practice Address - Street 1:2 HAVEN ST UNIT 202
Practice Address - Street 2:
Practice Address - City:READING
Practice Address - State:MA
Practice Address - Zip Code:01867-2959
Practice Address - Country:US
Practice Address - Phone:781-358-8191
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-06-01
Last Update Date:2021-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MADN1858050122300000X, 1223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics
No122300000XDental ProvidersDentist