=====================================================
General NPI Number Information
=====================================================
NPI Number | 1013223221
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | EMILY HAYES DDS DENTAL CENTER PC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/25/2010
-----------------------------------------------------
Last Update Date | 08/25/2010
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 101 E 63RD ST
-----------------------------------------------------
City | KANSAS CITY
-----------------------------------------------------
State | MO
-----------------------------------------------------
Zip | 64113-2222
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 816-333-1393
-----------------------------------------------------
Fax | 816-361-6275
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 101 E 63RD ST
-----------------------------------------------------
City | KANSAS CITY
-----------------------------------------------------
State | MO
-----------------------------------------------------
Zip | 64113-2222
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 816-333-1393
-----------------------------------------------------
Fax | 816-361-6275
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | DR. EMILY E. HAYES
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 816-333-1393
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 1223G0001X
-----------------------------------------------------
Taxonomy Name | General Practice Dentistry
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------