Provider Demographics
NPI:1740055854
Name:MATHEW, AJI ALEYAMA (DDS)
Entity type:Individual
Prefix:DR
First Name:AJI ALEYAMA
Middle Name:
Last Name:MATHEW
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 1:1472 ALCOVY FALLS DR
Mailing Address - Street 2:
Mailing Address - City:LAWRENCEVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30045-2200
Mailing Address - Country:US
Mailing Address - Phone:302-757-1294
Mailing Address - Fax:
Practice Address - Street 1:600 GARNETT ST
Practice Address - Street 2:
Practice Address - City:BUFORD
Practice Address - State:GA
Practice Address - Zip Code:30518-3200
Practice Address - Country:US
Practice Address - Phone:678-956-7092
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-11-17
Last Update Date:2023-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GADN1231981223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice