1982385522 NPI number — HAYANA NAM DMD

Table of content: HAYANA NAM DMD (NPI 1982385522)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1982385522 NPI number — HAYANA NAM DMD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
NAM
Provider First Name:
HAYANA
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
DMD
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1982385522
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/07/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PSC 444 BOX 1906
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
APO
Provider Business Mailing Address State Name:
AP
Provider Business Mailing Address Postal Code:
96297-0020
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
10-205-8472
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
BRIAN D. ALLGOOD ARMY COMMUNITY HOSPITAL (BDAACH)
Provider Second Line Business Practice Location Address:
UNIT 15245
Provider Business Practice Location Address City Name:
APO
Provider Business Practice Location Address State Name:
AP
Provider Business Practice Location Address Postal Code:
96271
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
10-205-8472
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
07/27/2023

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 122300000X , with the licence number:  13398715-9921 , registered in the state of UT ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)