Provider Demographics
NPI:1780411827
Name:AY DENTAL ASSOCIATES PLLC
Entity type:Organization
Organization Name:AY DENTAL ASSOCIATES PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:AYOMIDE
Authorized Official - Middle Name:
Authorized Official - Last Name:OGUNYE
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:832-928-7866
Mailing Address - Street 1:5703 MARTIN LUTHER KING BLVD
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77021-3224
Mailing Address - Country:US
Mailing Address - Phone:713-644-6595
Mailing Address - Fax:
Practice Address - Street 1:5703 MARTIN LUTHER KING BLVD
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77021-3224
Practice Address - Country:US
Practice Address - Phone:713-644-6595
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-13
Last Update Date:2024-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental