Noel Ayala

Individual provider Active NPI General Practice Dentistry · Hesperia, CA

NPI 1154977700 · NPPES record last updated Aug 9, 2019

Key facts

NPI
1154977700
Entity type
Individual (NPI type 1)
Primary specialty
General Practice Dentistry 1223G0001X
License
104137 (CA)
Practice address
18313 Bear Valley Rd
Hesperia, CA 92345-4970
Phone
(760) 949-2241
NPI assigned
Aug 9, 2019
Sex
Male
Sole proprietor
No

Organizations & group practices 1

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

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
104137CAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Wheeler Dental Group Inc. General Practice Past
since Aug 11, 2019
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 104137 CA Yes

Addresses

Primary practice location

18313 Bear Valley Rd
Hesperia, CA 92345-4970

Mailing address

47615 Corta Herrera
Indio, CA 92201-6877
Phone (760) 702-2160

Other providers in Hesperia, CA

All providers in Hesperia, CA · General Practice Dentistry in California

Sources for this page

Verify at the official NPI Registry.