Provider Demographics
NPI:1235026097
Name:AL KHAYYAT D D S INC
Entity type:Organization
Organization Name:AL KHAYYAT D D S INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:GENERAL DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:MUSTAFA
Authorized Official - Middle Name:
Authorized Official - Last Name:AL KHAYYAT
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:760-471-2231
Mailing Address - Street 1:825 W SAN MARCOS BLVD
Mailing Address - Street 2:
Mailing Address - City:SAN MARCOS
Mailing Address - State:CA
Mailing Address - Zip Code:92078-1112
Mailing Address - Country:US
Mailing Address - Phone:760-471-2231
Mailing Address - Fax:
Practice Address - Street 1:825 W SAN MARCOS BLVD
Practice Address - Street 2:
Practice Address - City:SAN MARCOS
Practice Address - State:CA
Practice Address - Zip Code:92078-1112
Practice Address - Country:US
Practice Address - Phone:760-471-2231
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-06-23
Last Update Date:2025-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty