Provider Demographics
NPI:1750662896
Name:AYAN, DARLENN GRACE (DMD,MAGD,FICOI)
Entity Type:Individual
Prefix:DR
First Name:DARLENN
Middle Name:GRACE
Last Name:AYAN
Suffix:
Gender:M
Credentials:DMD,MAGD,FICOI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:900 5TH AVE S
Mailing Address - Street 2:#204
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34102-6483
Mailing Address - Country:US
Mailing Address - Phone:239-732-9000
Mailing Address - Fax:239-775-9022
Practice Address - Street 1:900 5TH AVE S
Practice Address - Street 2:#204
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34102-6483
Practice Address - Country:US
Practice Address - Phone:239-732-9000
Practice Address - Fax:239-775-9022
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-02
Last Update Date:2011-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN 13772122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist