Ayman Atallah, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DN20191 Issued in FL

Practice address

410 Blanding Blvd Ste 6B
Orange Park, FL 32073-5065

Phone

(904) 276-5950

Fax

(904) 276-5359

NPI assigned

Jun 21, 2013

Last updated

Mar 4, 2019By 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 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

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

Networks

• Freedom Health HMO Network

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.

• Gem Dental PLLC

  • Dental Clinic/Center
  • Longwood, FL
  • NPI 1275481079
  NPD Authorized official

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

{
    "created_epoch": "1371772800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1551657600000",
    "number": "1275972390",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "651 NAUTICA DR",
            "address_2": "SUITE 1",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322187222",
            "telephone_number": "800-965-6470",
            "fax_number": "866-803-4943"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "410 BLANDING BLVD STE 6B",
            "city": "ORANGE PARK",
            "state": "FL",
            "postal_code": "320735065",
            "telephone_number": "904-276-5950",
            "fax_number": "904-276-5359"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ATALLAH",
        "first_name": "AYMAN",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-06-21",
        "last_updated": "2019-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN20191",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Fuchisa Artis
• Tara Asberry
• Hannan Asghar, M.D.
• Chiraag Ashokkumar, MD
• Aspire Counseling Inc
• Atkinson's Mart Inc (Atkinson's Hospital Pharmacy)
• Atkinsons Mart Inc (Atkinsons Healthcare)
• Atkinsons Mart Inc (Atkinson's Hospital Pharmacy)
• Christina Attidore, LMT
• Attunement, PLLC

• General Practice Dentistry in Orange Park, FL
• Providers in Orange Park, FL by specialty
• General Practice Dentistry in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2019; 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.