Healthcare Provider Details

I. General information

NPI: 1700378007
Provider Name (Legal Business Name): AMANDA HAYES DMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/01/2018
Last Update Date: 07/15/2026
Certification Date: 07/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19 NAHANT ST
LYNN MA
01902-5500
US

IV. Provider business mailing address

290 MISHAWUM RD UNIT 5043
WOBURN MA
01801-2280
US

V. Phone/Fax

Practice location:
  • Phone: 781-595-6639
  • Fax:
Mailing address:
  • Phone: 321-698-4519
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License NumberDN1858050
License Number StateMA
# 2
Primary TaxonomyN
Taxonomy Code122300000X
TaxonomyDentist
License NumberDN1858050
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: