Individual provider Active NPI

Ahmed Ayad Al Kayaly, DDS

  • General Practice Dentistry
  • Erie, PA
National Provider Identifier
1114595154
Registry record updated Jun 16, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DS043194 Issued in PA
Practice address
6660 Peach St # C12
Erie, PA 16509-7720
Phone
(814) 866-8650
NPI assigned
Jun 16, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 16, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X DS043194 PA Primary

Addresses

Primary practice location

6660 Peach St # C12
Erie, PA 16509-7720

Mailing address

5 Offshore Dr Apt 101
East Amherst, NY 14051-2293
Phone (281) 745-4965

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
DS043194PAMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1623801600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623801600000",
    "number": "1114595154",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 OFFSHORE DR APT 101",
            "city": "EAST AMHERST",
            "state": "NY",
            "postal_code": "140512293",
            "telephone_number": "281-745-4965"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6660 PEACH ST # C12",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165097720",
            "telephone_number": "814-866-8650"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AL KAYALY",
        "first_name": "AHMED",
        "middle_name": "AYAD",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-06-16",
        "last_updated": "2021-06-16",
        "certification_date": "2021-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "PA",
            "license": "DS043194",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Erie, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.