=====================================================
General NPI Number Information
=====================================================
NPI Number | 1154032977
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | HAIDYN TERANCE HELMER DDS
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/13/2022
-----------------------------------------------------
Last Update Date | 12/13/2022
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1970 N MAIN ST, SALINAS
-----------------------------------------------------
City | SALINAS
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 93906
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 831-424-4230
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2280 PEREZ ST APT 305
-----------------------------------------------------
City | SALINAS
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 93906-1786
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 707-339-0143
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 122300000X
-----------------------------------------------------
Taxonomy Name | Dentist
-----------------------------------------------------
License Number | 108192
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------