Provider Demographics
NPI:1366957995
Name:R HAYASHI DDS INC
Entity type:Organization
Organization Name:R HAYASHI DDS INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ACCOUNTANT
Authorized Official - Prefix:
Authorized Official - First Name:CAROLINE
Authorized Official - Middle Name:
Authorized Official - Last Name:DEVEREUX
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:949-481-5949
Mailing Address - Street 1:448 IGNACIO BLVD UNIT 319
Mailing Address - Street 2:
Mailing Address - City:NOVATO
Mailing Address - State:CA
Mailing Address - Zip Code:94949-6085
Mailing Address - Country:US
Mailing Address - Phone:949-481-5949
Mailing Address - Fax:877-739-4950
Practice Address - Street 1:301 RAILROAD AVE
Practice Address - Street 2:
Practice Address - City:RODEO
Practice Address - State:CA
Practice Address - Zip Code:94572-1126
Practice Address - Country:US
Practice Address - Phone:510-455-7486
Practice Address - Fax:877-739-4950
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-12-05
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental