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General NPI Number Information
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NPI Number | 1710448584
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Entity Type | Individual
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Provider Name | LENESHIA DENEA HAYNES DDS
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Gender | Female
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Dates
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Enumeration Date | 03/26/2019
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Last Update Date | 04/23/2020
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Provider Practice Location Address
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Address Line | 800 C M FAGAN DR STE A
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City | HAMMOND
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State | LA
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Zip | 70403-6062
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Country | US
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Telephone | 312-316-6056
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Fax |
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Provider Business Mailing Address
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Address Line | 2932 SAINT ANN ST
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City | NEW ORLEANS
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State | LA
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Zip | 70119-4128
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Country | US
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Telephone | 312-316-6056
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Fax |
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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 | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 6696
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License Number State | LA
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