Provider Demographics
NPI:1972394484
Name:BYNUM, ANDREW (DDS)
Entity type:Individual
Prefix:
First Name:ANDREW
Middle Name:
Last Name:BYNUM
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:77 GRAYS LNDG
Mailing Address - Street 2:
Mailing Address - City:HAMPTON
Mailing Address - State:VA
Mailing Address - Zip Code:23666-5621
Mailing Address - Country:US
Mailing Address - Phone:757-303-2897
Mailing Address - Fax:
Practice Address - Street 1:2900 N SAGINAW ST
Practice Address - Street 2:
Practice Address - City:FLINT
Practice Address - State:MI
Practice Address - Zip Code:48505-4452
Practice Address - Country:US
Practice Address - Phone:810-406-4246
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-14
Last Update Date:2025-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program