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General NPI Number Information
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NPI Number | 1497637565
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Entity Type | Individual
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Provider Name | ROMAN HAYES
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Gender | Male
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Dates
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Enumeration Date | 07/21/2025
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Last Update Date | 07/21/2025
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Provider Practice Location Address
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Address Line | 6230 W MANCHESTER AVE
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City | LOS ANGELES
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State | CA
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Zip | 90045-3801
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Country | US
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Telephone | 310-412-9291
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Fax |
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Provider Business Mailing Address
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Address Line | 2326 THOREAU ST
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City | INGLEWOOD
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State | CA
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Zip | 90303-2547
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Country | US
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Telephone | 714-768-7557
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Fax | 310-412-9291
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 124Q00000X
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Taxonomy Name | Dental Hygienist
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License Number | 28077
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License Number State | CA
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