Provider Demographics
NPI:1194816496
Name:FAYYAD, AYMAN (DMD)
Entity Type:Individual
Prefix:DR
First Name:AYMAN
Middle Name:
Last Name:FAYYAD
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2304 ARROWWOOD TRL
Mailing Address - Street 2:
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48105-1208
Mailing Address - Country:US
Mailing Address - Phone:248-622-0709
Mailing Address - Fax:248-622-0709
Practice Address - Street 1:715 E BIRCH ST STE A
Practice Address - Street 2:
Practice Address - City:BREA
Practice Address - State:CA
Practice Address - Zip Code:92821-5704
Practice Address - Country:US
Practice Address - Phone:714-790-6612
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-28
Last Update Date:2023-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2901019219122300000X
CA60205122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist