Provider Demographics
NPI:1407831084
Name:HAYAT ALI DDS INC
Entity Type:Organization
Organization Name:HAYAT ALI DDS INC
Other - Org Name:HAYAT DENTAL CENTERS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER DENTIST
Authorized Official - Prefix:MS
Authorized Official - First Name:HAYAT
Authorized Official - Middle Name:
Authorized Official - Last Name:ALI
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:216-476-9930
Mailing Address - Street 1:11501 LORAIN AVE
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44111-5402
Mailing Address - Country:US
Mailing Address - Phone:216-476-9930
Mailing Address - Fax:
Practice Address - Street 1:11501 LORAIN AVE
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44111-5402
Practice Address - Country:US
Practice Address - Phone:216-476-9930
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HAYAT ALI DDS INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2005-12-07
Last Update Date:2024-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH30020566122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2869543Medicaid
OH2003790Medicaid
4410OtherDORAL