Provider Demographics
NPI:1770686784
Name:AYOUB, SAMIR GEORGE (DDS)
Entity Type:Individual
Prefix:DR
First Name:SAMIR
Middle Name:GEORGE
Last Name:AYOUB
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 1:500 SUTTER ST
Mailing Address - Street 2:302
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94102-1107
Mailing Address - Country:US
Mailing Address - Phone:415-781-2227
Mailing Address - Fax:415-781-1417
Practice Address - Street 1:500 SUTTER ST
Practice Address - Street 2:302
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94102-1107
Practice Address - Country:US
Practice Address - Phone:415-781-2227
Practice Address - Fax:415-781-1417
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA251101223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice