Provider Demographics
NPI:1821611864
Name:AL-BEYATI, AIYA (DMD)
Entity Type:Individual
Prefix:DR
First Name:AIYA
Middle Name:
Last Name:AL-BEYATI
Suffix:
Gender:F
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 151
Mailing Address - Street 2:
Mailing Address - City:NEW CASTLE
Mailing Address - State:DE
Mailing Address - Zip Code:19720-0151
Mailing Address - Country:US
Mailing Address - Phone:302-652-2455
Mailing Address - Fax:302-322-6251
Practice Address - Street 1:1802 W 4TH ST
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19805-3420
Practice Address - Country:US
Practice Address - Phone:302-655-5822
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-05-26
Last Update Date:2023-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV45001223G0001X
PADS0430031223G0001X
390200000X
DEG8-CH000101223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program