Wissam Ayoub, DDS

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

55496 Issued in CA

Practice address

18800 Main St Ste 203
Huntington Beach, CA 92648-1718

Phone

(714) 848-2277

NPI assigned

Feb 5, 2007

Last updated

Sep 9, 2020By the provider in NPPES

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Ayoub Dental Corporation

  • Preferred Provider Organization
  • Huntington Beach, CA
  • NPI 1225498421
  Authorized official Same address or phone
• John Cohen D D S Dental Corporation

  dba Lennox Family Dental

  • Dental Clinic/Center
  • Lennox, CA
  • NPI 1366686214
  NPD
• John Cohen D D S Dental Corporation

  dba Dental Plus

  • Dental Clinic/Center
  • Wilmington, CA
  • NPI 1992192058

  Dentist

  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1170633600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1599609600000",
    "number": "1053450577",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18800 MAIN ST STE 203",
            "city": "HUNTINGTON BEACH",
            "state": "CA",
            "postal_code": "926481718",
            "telephone_number": "714-848-2277"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18800 MAIN ST STE 203",
            "city": "HUNTINGTON BEACH",
            "state": "CA",
            "postal_code": "926481718",
            "telephone_number": "714-848-2277"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1601 W Apache Trl",
            "address_2": "# 2",
            "address_purpose": "LOCATION",
            "city": "Apache Junction",
            "state": "AZ",
            "postal_code": "852203769",
            "country_code": "US",
            "telephone_number": "623-536-2040",
            "fax_number": "623-536-8555",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "AYOUB",
        "first_name": "WISSAM",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-05",
        "last_updated": "2020-09-09",
        "certification_date": "2020-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AZ",
            "license": "D7079",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "55496",
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "CA",
            "license": "55496",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Abigail Q Ayala
• Monica Ayala
• Ayoub Dental Corporation
• Marlize Atallah Ayoub, DDS
• Robby Tony Ayoub, MD
• Morgan Ayres
• Tyler Ayres
• John Baars, D.C.
• Darian Babe
• Diana Bach

• Oral and Maxillofacial Surgery (Dentist) in Huntington Beach, CA
• Providers in Huntington Beach, CA by specialty
• Oral and Maxillofacial Surgery (Dentist) in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.