MEDICARE: DR. ANNA HAYUT DDS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	122300000X	Dentist	39532	TX

General Provider Information

NPI Number	:	1821798810
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ANNA HAYUT DDS

Provider Business Mailing Address
First Line	:	1556 BRADFORD TRACE DR
Second Line	:
City	:	ALLEN
State	:	TX
Zip	:	75002-0962
Country	:	US
Telephone Number	:	972-865-5734
Fax Number	:

Provider Business Practice Location Address
First Line	:	1110 E PARKER RD STE 110
Second Line	:
City	:	PLANO
State	:	TX
Zip	:	75074-5363
Country	:	US
Telephone Number	:	972-265-0111
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/08/2023
Last Update Date	:	09/18/2023

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