Provider Demographics
NPI:1508086950
Name:ZRAIQAT, AYMAN AYOUB (DDS)
Entity Type:Individual
Prefix:DR
First Name:AYMAN
Middle Name:AYOUB
Last Name:ZRAIQAT
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 1:1401 N TUSTIN AVE STE 345
Mailing Address - Street 2:
Mailing Address - City:SANTA ANA
Mailing Address - State:CA
Mailing Address - Zip Code:92705-8657
Mailing Address - Country:US
Mailing Address - Phone:576-008-4256
Mailing Address - Fax:
Practice Address - Street 1:1401 N TUSTIN AVE STE 345
Practice Address - Street 2:
Practice Address - City:SANTA ANA
Practice Address - State:CA
Practice Address - Zip Code:92705-8657
Practice Address - Country:US
Practice Address - Phone:657-600-8425
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-26
Last Update Date:2024-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAD53665122300000X
CA53665122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist