Provider Demographics
NPI:1639969546
Name:DABNEY, AYDEN TYREE
Entity type:Individual
Prefix:
First Name:AYDEN
Middle Name:TYREE
Last Name:DABNEY
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6204 BROOKSIDE DR
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44144-1633
Mailing Address - Country:US
Mailing Address - Phone:330-717-4484
Mailing Address - Fax:
Practice Address - Street 1:4400 EUCLID AVE
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44103-3734
Practice Address - Country:US
Practice Address - Phone:216-431-5800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-12
Last Update Date:2025-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program