Provider Demographics
NPI:1982181632
Name:AYYASH, DEANNA FUAD (DDS)
Entity Type:Individual
Prefix:DR
First Name:DEANNA
Middle Name:FUAD
Last Name:AYYASH
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4940 SH 121 STE 115
Mailing Address - Street 2:
Mailing Address - City:THE COLONY
Mailing Address - State:TX
Mailing Address - Zip Code:75056-2928
Mailing Address - Country:US
Mailing Address - Phone:214-983-0413
Mailing Address - Fax:
Practice Address - Street 1:4940 SH 121 STE 115
Practice Address - Street 2:
Practice Address - City:THE COLONY
Practice Address - State:TX
Practice Address - Zip Code:75056-2928
Practice Address - Country:US
Practice Address - Phone:214-983-0413
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-07-25
Last Update Date:2021-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX344441223G0001X, 122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No1223G0001XDental ProvidersDentistGeneral Practice