Provider Demographics
NPI:1568508703
Name:JAFRI, AYAZ P (DMD)
Entity Type:Individual
Prefix:DR
First Name:AYAZ
Middle Name:P
Last Name:JAFRI
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:PO BOX 1080
Mailing Address - Street 2:
Mailing Address - City:OWOSSO
Mailing Address - State:MI
Mailing Address - Zip Code:48867-6080
Mailing Address - Country:US
Mailing Address - Phone:989-729-1999
Mailing Address - Fax:989-729-9949
Practice Address - Street 1:1425 N. M-52
Practice Address - Street 2:
Practice Address - City:OWOSSO
Practice Address - State:MI
Practice Address - Zip Code:48867-1234
Practice Address - Country:US
Practice Address - Phone:989-729-1999
Practice Address - Fax:989-729-9949
Is Sole Proprietor?:No
Enumeration Date:2007-01-29
Last Update Date:2022-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI29010167001223G0001X, 122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No1223G0001XDental ProvidersDentistGeneral Practice