Provider Demographics
NPI:1366960585
Name:HAYES, SASHA (DMD)
Entity type:Individual
Prefix:
First Name:SASHA
Middle Name:
Last Name:HAYES
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:SASHA
Other - Middle Name:
Other - Last Name:FRASER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5510 CHESTER GATE CT
Mailing Address - Street 2:
Mailing Address - City:MASON
Mailing Address - State:OH
Mailing Address - Zip Code:45040-7224
Mailing Address - Country:US
Mailing Address - Phone:270-799-9229
Mailing Address - Fax:
Practice Address - Street 1:658 CORWIN NIXON BLVD
Practice Address - Street 2:
Practice Address - City:SOUTH LEBANON
Practice Address - State:OH
Practice Address - Zip Code:45065-1248
Practice Address - Country:US
Practice Address - Phone:513-494-3111
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-09-07
Last Update Date:2022-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY10222122300000X
OH30.026995122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist