Provider Demographics
NPI:1104390715
Name:DR. AYOKI DDS PC
Entity Type:Organization
Organization Name:DR. AYOKI DDS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:EMILY
Authorized Official - Middle Name:BERYL
Authorized Official - Last Name:AYOKI-OTIENO
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:484-274-7394
Mailing Address - Street 1:940 RUBY CIR
Mailing Address - Street 2:
Mailing Address - City:GILBERTSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:19525-8414
Mailing Address - Country:US
Mailing Address - Phone:484-274-7394
Mailing Address - Fax:
Practice Address - Street 1:6901 HICKMAN RD
Practice Address - Street 2:
Practice Address - City:URBANDALE
Practice Address - State:IA
Practice Address - Zip Code:50322-4805
Practice Address - Country:US
Practice Address - Phone:515-270-5385
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-01-16
Last Update Date:2019-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1730569450Medicaid