Healthcare Provider Details

I. General information

NPI: 1356080840
Provider Name (Legal Business Name): KATHERINE JOYCE HAYES DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/02/2022
Last Update Date: 06/29/2022
Certification Date: 06/29/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

520 N 12TH ST
RICHMOND VA
23298-5064
US

IV. Provider business mailing address

751 BELLERIVE MANOR DR
CREVE COEUR MO
63141-6084
US

V. Phone/Fax

Practice location:
  • Phone: 804-828-9326
  • Fax:
Mailing address:
  • Phone: 314-761-5838
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number0442000459
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: