Provider Demographics
NPI:1437240777
Name:AYESH, KARIMA
Entity Type:Individual
Prefix:
First Name:KARIMA
Middle Name:
Last Name:AYESH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6704 NW 88TH AVE
Mailing Address - Street 2:
Mailing Address - City:TAMARAC
Mailing Address - State:FL
Mailing Address - Zip Code:33321-3725
Mailing Address - Country:US
Mailing Address - Phone:305-510-8249
Mailing Address - Fax:
Practice Address - Street 1:34000 MIDWAY AVE
Practice Address - Street 2:BLDG 595
Practice Address - City:APO
Practice Address - State:AA
Practice Address - Zip Code:92140
Practice Address - Country:US
Practice Address - Phone:619-532-6471
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-28
Last Update Date:2014-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN177331223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice