Healthcare Provider Details

I. General information

NPI: 1134409592
Provider Name (Legal Business Name): BRANT DANIEL HAYNIE D.M.D
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/17/2011
Last Update Date: 04/29/2026
Certification Date: 04/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2729 RAINBOW DR
RAINBOW CITY AL
35906-5815
US

IV. Provider business mailing address

2729 RAINBOW DR
RAINBOW CITY AL
35906-5815
US

V. Phone/Fax

Practice location:
  • Phone: 256-442-8081
  • Fax: 256-442-8082
Mailing address:
  • Phone: 256-442-8081
  • Fax: 256-442-8082

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number5827
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: