Provider Demographics
NPI:1114595154
Name:AL KAYALY, AHMED AYAD (DDS)
Entity Type:Individual
Prefix:
First Name:AHMED
Middle Name:AYAD
Last Name:AL KAYALY
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 OFFSHORE DR APT 101
Mailing Address - Street 2:
Mailing Address - City:EAST AMHERST
Mailing Address - State:NY
Mailing Address - Zip Code:14051-2293
Mailing Address - Country:US
Mailing Address - Phone:281-745-4965
Mailing Address - Fax:
Practice Address - Street 1:6660 PEACH ST # C12
Practice Address - Street 2:
Practice Address - City:ERIE
Practice Address - State:PA
Practice Address - Zip Code:16509-7720
Practice Address - Country:US
Practice Address - Phone:814-866-8650
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-16
Last Update Date:2021-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS0431941223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice